I11.0 — Hypertensive heart disease with heart failure
I11.0 is a billable, specific ICD-10-CM code for hypertensive heart disease with heart failure. It is valid for submission on a claim.
Use additional code
Add a secondary code to capture the detail described below.
- code to identify type of heart failure (I50.-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Hypertensive heart failure
Other codes that can never be billed with I11.0
These codes carry an Excludes1 note pointing at I11.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I11.0 alone.
Risk adjustment
I11.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 226 Heart Failure, Except End Stage and Acute0.360 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
I11.0 is named in 46 Medicare coverage policies — 46 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A53026Billing and Coding: Bariatric Surgery Coverage
How I11.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I11.0.
- Hypertension, hypertensive›with›heart failure(congestive)
- Hypertension, hypertensive›heart›with›heart failure(congestive)
The condition this code belongs to
Every code for the condition on one page, which one applies when, and the mistake coders make with it.
Code history
I11.0 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share I11. If I11.0 is not quite right, the correct code is usually one of these.
Questions about I11.0
- Is I11.0 a billable ICD-10-CM code?
- Yes. I11.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I11.0 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Hypertensive diseases (I10-I1A).