I13.11: Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
I13.11 is a billable, specific ICD-10-CM code for hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease. It is valid for submission on a claim.
Check I13.11 with the rest of the claim: free scrubberOther codes that can never be billed with I13.11
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
I13.11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 326 Chronic Kidney Disease, Stage 50.815 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
I13.11 is named in 29 Medicare coverage policies: 29 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A53026Billing and Coding: Bariatric Surgery Coverage
- A54923Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
- A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Alphabetic index entries that lead here
- Hypertension, hypertensive›cardiorenal›without heart failure›with stage 5 or end stage renal disease
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.