ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I12.0

Billable / Specific CC

Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease

I12
Block
0
Synonyms
549
LCDs
31
Payer Policies
72
Linked CPTs

About ICD-10-CM I12.0

ICD-10-CM code I12.0 represents Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease. This is a billable/specific code in the Circulatory System chapter (block I12). The 2026 edition of ICD-10-CM I12.0 became effective on October 1, 2025.

Coding Tips for I12.0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

I12.0 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Use Additional Code

When coding I12.0, also report these additional codes when applicable.

  • code to identify the stage of chronic kidney disease (N18.5, N18.6)

Inpatient DRG Impact, CC

codes Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I12.0

Local Coverage Determinations (LCDs) from CMS MACs that list I12.0 as a covered diagnosis.

549 LCDs

Showing top 10 of 549 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8918 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8936 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8910 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70548 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8913 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8912 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8914 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70547 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8901 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8902 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I12.0.

31 policies

2 Cigna

Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)
Policy ID: MM_0551
Vitamin D Testing - (0526) ---- future effective policy
Policy ID: MM_0526

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
Policy ID: ART-54923
Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423

CPT Codes Commonly Billed with I12.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

72 linkages
  • 93979 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93975 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93976 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93978 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93980 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 93981 CMS LCD: Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies CMS LCD
  • 36254 CMS LCD: Billing and Coding: Diagnostic Abdominal Aortography and Renal Angiography CMS LCD
  • 36252 CMS LCD: Billing and Coding: Diagnostic Abdominal Aortography and Renal Angiography CMS LCD
  • 36247 CMS LCD: Billing and Coding: Diagnostic Abdominal Aortography and Renal Angiography CMS LCD
  • 75630 CMS LCD: Billing and Coding: Diagnostic Abdominal Aortography and Renal Angiography CMS LCD

Convert I12.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I12.0 40301 10000
I12.0 40311 10000
I12.0 40391 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To I12.0

Other codes in section I10-I1A (Hypertensive diseases).

ICD-10 I12.0, Billing FAQ

Is ICD-10 code I12.0 billable? +

Yes, I12.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is I12.0 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with I12.0? +

Procedures frequently paired with I12.0 include: 93979, 93975, 93976, 93978, 93980.

What ICD-9 codes does I12.0 map to? +

Per CMS GEMs, I12.0 maps to ICD-9 codes: 40301, 40311, 40391. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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