I11 ICD-10-CM Code: Hypertensive heart disease

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I11 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on I11 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for I11

MedCoder structured workflow — derived from this code’s own official record

Before you code I11

1. I11 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewI11.0, I11.9

   See the relationships section · Guide: How to choose an ICD-10-CM code →

2. Check the record for heart involvement, chronic kidney disease, a documented cause, crisis, resistance, or pregnancy: each moves the case to a different category in I10–I16 and I1A, and the classification presumes the heart and kidney links unless the provider states they are unrelated. The hypertension guideline and the “with” convention (Guidelines I.C.9.a, I.A.15).

   Guide: The "with" convention →

3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I11. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support one of the more specific codes beneath I11?
   Yes → Select that code and continue the checks below on its own page.
   No → I11 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewI11.0, I11.9

2. Does the documentation support a condition named in I11’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewP29.2, I27.0

Consider I11. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

The conditions the Use Additional Code note names

Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Heart involvement, chronic kidney disease and its stage, cause, crisis, pregnancy

Each moves the case to a different hypertension category (Guidelines I.C.9.a).

Official instructions as workflow

• Excludes1 — check before selecting I11(2 notes)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I11: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareP29.2, I27.0

  See the official tabular notes · Guidelines I.A.12.a

• Excludes2 — not part of I11(1 note)

  Coding workflow: The conditions named in this note are not included in I11. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  See the official tabular notes · Guidelines I.A.12.b

• Use Additional Code — after identifying I11(6 notes)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I11 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

  ReviewZ77.22, Z87.891, Z57.31, F17, Z72.0

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Don’t confuse I11 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of I11 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• P29.2— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of neonatal hypertension moves the case to P29.2; the two are not reported together unless documented as unrelated.

  Full comparison: I11 vs P29.2 →

• I27.0— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of primary pulmonary hypertension moves the case to I27.0; the two are not reported together unless documented as unrelated.

  Full comparison: I11 vs I27.0 →

• O10— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of hypertensive disease complicating pregnancy, childbirth and the puerperium adds O10; it is not part of this code and both may be reported when both are documented.

  Full comparison: I11 vs O10 →

• O11— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of hypertensive disease complicating pregnancy, childbirth and the puerperium adds O11; it is not part of this code and both may be reported when both are documented.

  Full comparison: I11 vs O11 →

• O13— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of hypertensive disease complicating pregnancy, childbirth and the puerperium adds O13; it is not part of this code and both may be reported when both are documented.

  Full comparison: I11 vs O13 →

• O16— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of hypertensive disease complicating pregnancy, childbirth and the puerperium adds O16; it is not part of this code and both may be reported when both are documented.

  Full comparison: I11 vs O16 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. 6 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
2. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
3. 1 Excludes2 entry — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

• Not billable as written — a more specific code is required: I11.0, I11.9.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name I11 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: I51.5 — Myocardial degeneration, I51.7 — Cardiomegaly.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Code Also instructions: I16 — Hypertensive crisis, I67.4 — Hypertensive encephalopathy, I87.2 — Venous insufficiency (chronic) (peripheral).

These codes suggest coding this condition alongside when both are present.

Contextual Map

Every relationship of I11 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I11 with these 18 related codes in Claim Check

Hierarchy

• I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I10-I1A — Hypertensive diseases[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes1

• I27.0 — Primary pulmonary hypertension[Excludes1]: “primary pulmonary hypertension (I27.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• P29.2 — Neonatal hypertension[Excludes1]: “neonatal hypertension (P29.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Excludes2

• O10 — Pre-existing hypertension complicating pregnancy, childbirth and the puerperium[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O11 — Pre-existing hypertension with pre-eclampsia[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O13 — Gestational [pregnancy-induced] hypertension without significant proteinuria[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O14 — Pre-eclampsia[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O15 — Eclampsia[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• O16 — Unspecified maternal hypertension[Excludes2]: “hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Use Additional Code

• F17 — Nicotine dependence[Use Additional Code]: “tobacco dependence (F17.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• Z57.31 — Occupational exposure to environmental tobacco smoke[Use Additional Code]: “occupational exposure to environmental tobacco smoke (Z57.31)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• Z72.0 — Tobacco use[Use Additional Code]: “tobacco use (Z72.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• Z77.22 — Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)[Use Additional Code]: “exposure to environmental tobacco smoke (Z77.22)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• Z87.891 — Personal history of nicotine dependence[Use Additional Code]: “history of tobacco dependence (Z87.891)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

• I51.5 — Myocardial degeneration[Excludes1]: “myocardial degeneration due to hypertension (I11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I51.7 — Cardiomegaly[Excludes1]: “cardiomegaly due to hypertension (I11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

• I16 — Hypertensive crisis[Code Also]: “any identified hypertensive disease (I10-I15, I1A)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I67.4 — Hypertensive encephalopathy[Code Also]: “hypertensive heart disease (I11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• I87.2 — Venous insufficiency (chronic) (peripheral)[Code Also]: “hypertensive heart disease (I11.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Nearest codes

• I11.0 — Hypertensive heart disease with heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• I11.9 — Hypertensive heart disease without heart failure[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Relevant guides

• The “With” Convention: When ICD-10-CM Presumes Two Conditions Are Related →

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I11 in its code family, with their registry titles.

• I11.0 — Hypertensive heart disease with heart failure
• I11.9 — Hypertensive heart disease without heart failure