HTN + CKD + CHF combo code


Please help me with this case: patient with history of HTN, CHF and CKD presented with HTN urgency and AKI. My colleague asked me whether he can make the combo code as a principal diagnosis ? I am not sure what to say. What I know is a patient with HTN, CKD and CHF presented with acute on chronic CHF, I can make the combo code as a principal Dx. Would you please help us to resolve this dilemma ?



  • The sequencing htn/ckd/hf as pdx depends on code first instructional notes (ie. I50 codes and esrd instructional notes), Official Coding Guidelines discusses it, as does Coding Clinics.

    If this patient had acute on chronic HF on arrival and it meets the definition of the principal, per official coding gudielines regarding the selection of principal diagnosis, then the combo code would be the principal based on code 1st requirements.

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