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I13.11 ICD-10-CM Code: Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
3 inclusion terms · 2 Excludes1 · 1 Excludes2 · 7 use-additional codes
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 136 · RxHCC V08 category 187 · RxHCC V08 category 262

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code to identify the stage of chronic kidney disease (N18.5, N18.6)
  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)

+3 more in Instructions

Excludes1Never report with this code
  • neonatal hypertension (P29.2)
  • primary pulmonary hypertension (I27.0)
Excludes2Not included here; may be reported together
  • hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)
IncludesWhat this code covers
  • any condition in I11.- with any condition in I12.-
  • cardiorenal disease
  • cardiovascular renal disease

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 008 — SIMULTANEOUS PANCREAS, ISLET CELL AND KIDNEY TRANSPLANT (MDC PRE)
  • MS-DRG 019 — SIMULTANEOUS PANCREAS, ISLET CELL AND KIDNEY TRANSPLANT WITH HEMODIALYSIS (MDC PRE)
  • MS-DRG 673 — OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC (MDC 11)
  • MS-DRG 674 — OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC (MDC 11)
  • MS-DRG 675 — OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC (MDC 11)
  • MS-DRG 682 — RENAL FAILURE WITH MCC (MDC 11)
  • MS-DRG 683 — RENAL FAILURE WITH CC (MDC 11)
  • MS-DRG 684 — RENAL FAILURE WITHOUT CC/MCC (MDC 11)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 326 — Chronic Kidney Disease, Stage 5 (supersedes HCC 327, HCC 328, HCC 329)

Other models: CMS-HCC V22 HCC 136 · RxHCC V08 HCC 187 · RxHCC V08 HCC 262

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I13.11 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on I13.11 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • any condition in I11.- with any condition in I12.-
  • cardiorenal disease
  • cardiovascular renal disease

Source: inherited from I13

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from I10-I1A

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from I10-I1A

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify the stage of chronic kidney disease (N18.5, N18.6)
  • Use additional code to identify:
  • exposure to environmental tobacco smoke (Z77.22) inherited from I10-I1A
  • history of tobacco dependence (Z87.891) inherited from I10-I1A
  • occupational exposure to environmental tobacco smoke (Z57.31) inherited from I10-I1A
  • tobacco dependence (F17.-) inherited from I10-I1A
  • tobacco use (Z72.0) inherited from I10-I1A

Coder workflow for I13.11

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

Before you code I13.11

  1. 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 →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I13.11. 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 a condition named in I13.11’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 I13.11. 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).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
Stage
The documented stage decides the sibling code; where a Use Additional Code note asks for a stage code, report it as well.
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
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 I13.11(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I13.11: 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 I13.11(1 note)

    Coding workflow: The conditions named in this note are not included in I13.11. 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 I13.11(7 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I13.11 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewN18.5, N18.6, Z77.22, Z87.891, Z57.31, F17

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

Coding decision scenarios

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

Documentation: Both the condition I13.11 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewP29.2, I27.0

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with I13.11?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewN18.5, N18.6, Z77.22, Z87.891, Z57.31, F17

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.

Don’t confuse I13.11 with…

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

The codes most likely to be picked instead of I13.11 — 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: I13.11 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: I13.11 vs I27.0 →

  • I13.10— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease” takes I13.10; specificity in the record moves it back here.

    Full comparison: I13.11 vs I13.10 →

  • 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: I13.11 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: I13.11 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: I13.11 vs O13 →

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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease is a billable ICD-10-CM diagnosis code (I13.11).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding 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.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

a. Hypertension The classification presumes a causal relationship between hypertension and heart involvement and between hypertension and kidney involvement, as the two conditions are linked by the term “with” in the Alphabetic Index. These conditions should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

3) Hypertensive Heart and Chronic Kidney Disease The codes in category I13, Hypertensive heart and chronic kidney disease, are combination codes that include hypertension, heart disease and chronic kidney disease. Assign codes from combination category I13, Hypertensive heart and chronic kidney disease, when there is hypertension with both heart and chronic kidney disease. If heart failure is present, assign an additional code from category I50 to identify the type of heart failure.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

The ap propriate code from category N18, Chronic kidney disease, should be used as a secondary code with a code from category I13 to identify the stage of chronic kidney disease.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

The Includes note at I13 specifies that the conditions included at I11 and I12 are included together in I13. If a patient has hypertension, heart disease and chronic kidney disease, then a code from I13 should be used, not codes from I11 or I12, For patients with both acute renal failure and chronic kidney disease, the acute renal failure should also be coded. Sequence according to the circumstances of the admission/encounter.

Decision Points

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

  1. 7 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

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name I13.11 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 (via I13.-), I51.7 — Cardiomegaly (via I13.-).

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

Referenced by 2 Code First instructions across 2 chapters: I50 — Heart failure (via I13.-), N18 — Chronic kidney disease (CKD) (via I13.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 4 Code Also instructions: I16 — Hypertensive crisis (via I13.-), I27.29 — Other secondary pulmonary hypertension, I67.4 — Hypertensive encephalopathy (via I13.-), I87.2 — Venous insufficiency (chronic) (peripheral) (via I13.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 26 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 8 MS-DRGs: DRG 008 (MDC PRE), DRG 019 (MDC PRE), DRG 673 (MDC 11), DRG 674 (MDC 11), DRG 675 (MDC 11), DRG 682 (MDC 11), DRG 683 (MDC 11), DRG 684 (MDC 11).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):GEN003 — Chronic kidney disease (default); CIR008 — Hypertension with complications and secondary hypertension.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

I10 — Essential (primary) hypertension, I11.0 — Hypertensive heart disease with heart failure, I11.9 — Hypertensive heart disease without heart failure, I12.0 — Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease, I12.9 — Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.0 — Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.10 — Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease, I15.0 — Renovascular hypertension, I15.1 — Hypertension secondary to other renal disorders, I15.2 — Hypertension secondary to endocrine disorders, I15.8 — Other secondary hypertension, I15.9 — Secondary hypertension, unspecified, I16.0 — Hypertensive urgency, I16.1 — Hypertensive emergency, I16.9 — Hypertensive crisis, unspecified, I1A.0 — Resistant hypertension, I27.841 — Fontan-associated lymphatic dysfunction, I27.848 — Other Fontan-associated condition, I27.849 — Fontan related circulation, unspecified, +5 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Kidney Disease, Stage 5) for risk-adjusted payment.

I12.0 — Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease, I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease, N18.5 — Chronic kidney disease, stage 5, N18.6 — End stage renal disease

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Chronic Kidney Disease, Severe (Stage 4), Chronic Kidney Disease, Moderate (Stage 3B), Chronic Kidney Disease, Moderate (Stage 3, Except 3B)

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Chronic kidney disease, Hypertension with complications and secondary hypertension).

E13.22 — Other specified diabetes mellitus with diabetic chronic kidney disease, H35.031 — Hypertensive retinopathy, right eye, H35.032 — Hypertensive retinopathy, left eye, H35.033 — Hypertensive retinopathy, bilateral, I11.0 — Hypertensive heart disease with heart failure, I11.9 — Hypertensive heart disease without heart failure, I12.0 — Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease, I12.9 — Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.0 — Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.10 — Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease, I13.2 — Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease, I15.0 — Renovascular hypertension, I15.1 — Hypertension secondary to other renal disorders, I15.2 — Hypertension secondary to endocrine disorders, I15.8 — Other secondary hypertension, I15.9 — Secondary hypertension, unspecified, I16.0 — Hypertensive urgency, I16.1 — Hypertensive emergency, I16.9 — Hypertensive crisis, unspecified, I1A.0 — Resistant hypertension, +58 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Hypertension, hypertensive”; these codes share that main term but sit in a different category of the Tabular List.

B65.9 — Schistosomiasis, unspecified (portal, in), F45.8 — Other somatoform disorders (psychogenic), G93.2 — Benign intracranial hypertension (benign, intracranial), H40.05 — Ocular hypertension (ocular), I10 — Essential (primary) hypertension, I11.0 — Hypertensive heart disease with heart failure (with, heart failure), I11.9 — Hypertensive heart disease without heart failure (heart), I12.0 — Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease (kidney, with, stage 5 chronic kidney disease), I12.9 — Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease (kidney), I15.0 — Renovascular hypertension (renovascular), I15.1 — Hypertension secondary to other renal disorders (due to, renal disorders NEC), I15.2 — Hypertension secondary to endocrine disorders (due to, pheochromocytoma), I15.8 — Other secondary hypertension (secondary NEC, specified NEC), I15.9 — Secondary hypertension, unspecified (secondary NEC), I16.0 — Hypertensive urgency (urgency), I16.1 — Hypertensive emergency (emergency), I16.9 — Hypertensive crisis, unspecified (crisis), I1A.0 — Resistant hypertension (resistant), I26.09 — Other pulmonary embolism with acute cor pulmonale (pulmonary, with, cor pulmonale, acute), I27.0 — Primary pulmonary hypertension (lesser circulation), +51 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Iron Panel, Lipid Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR), Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of I13.11 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 I13.11 with these 10 related codes in Claim Check

Hierarchy

Use Additional Code

  • N18.5 — Chronic kidney disease, stage 5[Use Additional Code]: “code to identify the stage of chronic kidney disease (N18.5, N18.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • N18.6 — End stage renal disease[Use Additional Code]: “code to identify the stage of chronic kidney disease (N18.5, N18.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Excludes1 notes

  • I51.5 — Myocardial degeneration[Excludes1](via I13.-): “myocardial degeneration due to hypertension and chronic kidney disease (I13.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • I51.7 — Cardiomegaly[Excludes1](via I13.-): “cardiomegaly due to hypertension and chronic kidney disease (I13.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code First instructions

  • I50 — Heart failure[Code First](via I13.-): “heart failure due to hypertension with chronic kidney disease (I13.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • N18 — Chronic kidney disease (CKD)[Code First](via I13.-): “hypertensive chronic kidney disease (I12.-, I13.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 326 — Chronic Kidney Disease, Stage 5 [CMS-HCC]: “Chronic Kidney Disease, Stage 5 — supersedes HCC 327 (Chronic Kidney Disease, Severe (Stage 4)), HCC 328 (Chronic Kidney Disease, Moderate (Stage 3B)), HCC 329 (Chronic Kidney Disease, Moderate (Stage 3, Except 3B))”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 175 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 11 — Diseases and Disorders of the Kidney and Urinary Tract[MDC crossing]: “Diseases and Disorders of the Kidney and Urinary Tract — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 3,578 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Hypertension, hypertensive (accelerated) (benign) (essential) (idiopathic) (malignant) (systemic), cardiorenal (disease), without heart failure, with stage 5 or end stage renal disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

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

Relevant guides

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Common coding questions

MedCoder editorial

What distinguishes I13.11 from I13.10?

The kidney stage alone: I13.11 is the same no-heart-failure combination with stage 5 CKD or ESRD, pairing with N18.5 or N18.6 per its Use Additional Code note. That one-character difference also moves the code from no HCC to V28 HCC 326, Chronic Kidney Disease, Stage 5.

If heart failure develops in a patient coded I13.11, what changes?

The combination becomes I13.2 — the with-heart-failure, stage-5 code — and an I50.- code joins the claim for the failure type. The presumed relationships never need re-documenting as the combination shifts; only the clinical facts do. The “with” convention explains why.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I13.11 — Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i13.11-hypertensive-heart-and-chronic-kidney-disease-without-heart-failure-with-stage-5-chronic-kidney-disease-or-end-stage-renal-disease

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I13.11 in its code family, with their registry titles.

View all codes in the I13 family