I12.0 ICD-10-CM Code: Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Hypertensive diseases (I10-I1A)
I12.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
High blood pressure that has severely damaged the kidneys, resulting in stage 5 chronic kidney disease or end-stage renal disease requiring dialysis or transplant.
Buddy Insight
Hypertensive chronic kidney disease with stage 5 or end-stage renal disease represents the most advanced stage of kidney disease attributed to hypertension.
CMS-HCC V28
MappedHCC 326
RAF 0.815
CMS-HCC V24
MappedHCC 136
RAF 0.289
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 136
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I12.0 in this effective period.
Excludes 2
Official- acute kidney failure (N17.-)
Related Child Codes
Includes
Official- any condition in N18 and N26 - due to hypertension
- arteriosclerosis of kidney
- arteriosclerotic nephritis (chronic) (interstitial)
- hypertensive nephropathy
- nephrosclerosis
Excludes 1
Official- hypertension due to kidney disease (I15.0, I15.1)
- renovascular hypertension (I15.0)
- secondary hypertension (I15.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I12.0 in this effective period.
Use Additional
Official- code to identify the stage of chronic kidney disease (N18.5, N18.6)
Code Also
OfficialICD-10-CM does not list Code Also instructions for I12.0 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is I12.0 an HCC code?
Yes. I12.0 maps to Chronic Kidney Disease, Stage 5 under the CMS-HCC V28 risk adjustment model (and Chronic Kidney Disease, Stage 5 under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work I12.0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I12.0
For I12.0to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I12.0 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I12.0 is the ICD-10-CM diagnosis code for hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease. High blood pressure that has severely damaged the kidneys, resulting in stage 5 chronic kidney disease or end-stage renal disease requiring dialysis or transplant. I12.0 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering hypertensive diseases (i10-i1a).
Under the CMS-HCC V28 risk adjustment model, I12.0 maps to Chronic Kidney Disease, Stage 5 (HCC 326) with a community, non-dual, aged base RAF weight of 0.815. Under the older V24 model, I12.0 mapped to the same category but with a base RAF weight of 0.289, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
I12.0 is specifically for stage 5 CKD or ESRD; verify the CKD stage is documented as stage 5 before assigning this code. Because I12.0 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I12.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •I12.0 is specifically for stage 5 CKD or ESRD; verify the CKD stage is documented as stage 5 before assigning this code
- •Link the hypertension causally to the kidney disease; do not use if kidney disease is from another cause
Clinical Significance
Hypertensive chronic kidney disease with stage 5 or end-stage renal disease represents the most advanced stage of kidney disease attributed to hypertension. This combination code carries substantial risk adjustment weight, reflecting the extremely high cost and complexity of managing patients with advanced kidney failure requiring dialysis or transplantation alongside chronic hypertension.
Documentation Requirements
- ✓Documented diagnosis of hypertension
- ✓Documented chronic kidney disease stage 5 or end-stage renal disease (ESRD)
- ✓An additional code MUST be assigned to identify the stage of CKD: N18.5 (stage 5) or N18.6 (ESRD)
- ✓Current estimated glomerular filtration rate (eGFR) supporting stage 5 (< 15 mL/min)
- ✓Dialysis status if applicable (Z99.2 for dialysis dependence)
- ✓Kidney transplant status if applicable (Z94.0)
- ✓Current treatment regimen for both hypertension and kidney disease
- ✓Note: Per ICD-10 guidelines, coexistence of hypertension and CKD assumes a causal relationship
Commonly Confused Codes
- •I12.9: Hypertensive CKD with stages 1-4 or unspecified (use for earlier stages of CKD)
- •I13.11: Hypertensive heart and CKD without heart failure, with stage 5/ESRD (use when heart disease is also present)
- •I13.2: Hypertensive heart and CKD with heart failure and stage 5/ESRD (use when heart failure AND heart disease are present)
- •N18.5: Chronic kidney disease stage 5 (additional code to assign WITH I12.0, not instead of)
- •N18.6: End-stage renal disease (additional code to assign WITH I12.0, not instead of)