FY 2026 OFFICIAL GUIDELINES
ICD-10-CM Chapter 9
Diseases of the Circulatory System
I00 – I99 | Complete Coding Guidelines with Disease Definitions
Hypertension CAD & Angina CVA AMI Types 1–5 MINOCA / CMD Sequelae
Advanced Coder Training Series • 20 Slides • Sections a – e
, Session Roadmap — 20 Slides
Full definitions + guideline rules for every condition in Chapter 9
Slides 3–10 — Hypertension
› Essential, Secondary, Resistant HTN definitions
› HTN Heart Disease (I11) with definitions
› HTN Chronic Kidney Disease (I12)
› HTN Heart + CKD (I13)
› Hypertensive Crisis, Cerebrovascular, Retinopathy
› Pulmonary Hypertension
Slides 11–20 — CAD, CVA, AMI
› Atherosclerosis, Angina definitions
› CAD combination code rules
› Cerebrovascular disease definitions
› Sequelae of CVD (I69)
› AMI Types 1–5 with full definitions
› New codes: I21.B, I1A.0
FY2026 NEW CODES COVERED
I21.B Myocardial Infarction with Coronary Microvascular Dysfunction (includes MINOCA with CMD)
I1A.0 Resistant Hypertension — blood pressure above goal despite antihypertensive therapy
HOW TO USE THIS PRESENTATION
Each slide opens with a clinical definition of the disease(s) involved, followed by the applicable ICD-10-CM coding guideline rules. Use arrow keys or navigation buttons to advance.
, Essential (Primary) Hypertension — I10
Section a — The foundational HTN code and the "With" Presumption Rule
DISEASE DEFINITION
Essential (Primary) Hypertension
A chronic medical condition in which blood pressure in the arteries is persistently elevated (≥130/80 mmHg per AHA; ≥140/90 mmHg per WHO) without an identifiable secondary cause. It
accounts for 90–95% of all hypertension cases. Also called idiopathic hypertension. Risk factors include genetics, obesity, high-sodium diet, sedentary lifestyle, and aging. It is the single most
important modifiable risk factor for cardiovascular disease.
CONTROLLED VS. UNCONTROLLED
Controlled HTN
HTN managed to target BP levels through pharmacological or lifestyle therapy. Does not imply resolved — the diagnosis persists.
Uncontrolled HTN
Either untreated HTN or HTN that fails to respond to the current therapeutic regimen.
Coding Rule — The "With" Presumption
› ICD-10-CM presumes HTN causes heart AND kidney involvement (linked by "with" in the Alphabetic Index)
› Code as related even without explicit provider documentation
› UNLESS provider clearly states the conditions are unrelated
› For ALL OTHER conditions: provider must document the link
✅ CONTROLLED & UNCONTROLLED
Both use the same codes I10–I15 . There is no separate "controlled" or "uncontrolled" code. Assign per the type of hypertension regardless of control status.
⛔ TRANSIENT HTN
If patient has NO established HTN diagnosis, use R03.0 — elevated BP reading. Never assign I10 without a confirmed diagnosis.
ICD-10-CM Chapter 9
Diseases of the Circulatory System
I00 – I99 | Complete Coding Guidelines with Disease Definitions
Hypertension CAD & Angina CVA AMI Types 1–5 MINOCA / CMD Sequelae
Advanced Coder Training Series • 20 Slides • Sections a – e
, Session Roadmap — 20 Slides
Full definitions + guideline rules for every condition in Chapter 9
Slides 3–10 — Hypertension
› Essential, Secondary, Resistant HTN definitions
› HTN Heart Disease (I11) with definitions
› HTN Chronic Kidney Disease (I12)
› HTN Heart + CKD (I13)
› Hypertensive Crisis, Cerebrovascular, Retinopathy
› Pulmonary Hypertension
Slides 11–20 — CAD, CVA, AMI
› Atherosclerosis, Angina definitions
› CAD combination code rules
› Cerebrovascular disease definitions
› Sequelae of CVD (I69)
› AMI Types 1–5 with full definitions
› New codes: I21.B, I1A.0
FY2026 NEW CODES COVERED
I21.B Myocardial Infarction with Coronary Microvascular Dysfunction (includes MINOCA with CMD)
I1A.0 Resistant Hypertension — blood pressure above goal despite antihypertensive therapy
HOW TO USE THIS PRESENTATION
Each slide opens with a clinical definition of the disease(s) involved, followed by the applicable ICD-10-CM coding guideline rules. Use arrow keys or navigation buttons to advance.
, Essential (Primary) Hypertension — I10
Section a — The foundational HTN code and the "With" Presumption Rule
DISEASE DEFINITION
Essential (Primary) Hypertension
A chronic medical condition in which blood pressure in the arteries is persistently elevated (≥130/80 mmHg per AHA; ≥140/90 mmHg per WHO) without an identifiable secondary cause. It
accounts for 90–95% of all hypertension cases. Also called idiopathic hypertension. Risk factors include genetics, obesity, high-sodium diet, sedentary lifestyle, and aging. It is the single most
important modifiable risk factor for cardiovascular disease.
CONTROLLED VS. UNCONTROLLED
Controlled HTN
HTN managed to target BP levels through pharmacological or lifestyle therapy. Does not imply resolved — the diagnosis persists.
Uncontrolled HTN
Either untreated HTN or HTN that fails to respond to the current therapeutic regimen.
Coding Rule — The "With" Presumption
› ICD-10-CM presumes HTN causes heart AND kidney involvement (linked by "with" in the Alphabetic Index)
› Code as related even without explicit provider documentation
› UNLESS provider clearly states the conditions are unrelated
› For ALL OTHER conditions: provider must document the link
✅ CONTROLLED & UNCONTROLLED
Both use the same codes I10–I15 . There is no separate "controlled" or "uncontrolled" code. Assign per the type of hypertension regardless of control status.
⛔ TRANSIENT HTN
If patient has NO established HTN diagnosis, use R03.0 — elevated BP reading. Never assign I10 without a confirmed diagnosis.
