ICD-10 I13.2
Billable / Specific HCC v28: 136 CCHypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
About ICD-10-CM I13.2
ICD-10-CM code I13.2 represents Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease. This is a billable/specific code in the Circulatory System chapter (block I13). The 2026 edition of ICD-10-CM I13.2 became effective on October 1, 2025.
Coding Tips for I13.2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I13.2 is a CMS-HCC v28 risk-adjustment code (category 136). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
I13.2 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 I13.2, also report these additional codes when applicable.
- code to identify type of heart failure (I50.-)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Hypertensive heart and chronic kidney disease with heart failure and 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 I13.2
Local Coverage Determinations (LCDs) from CMS MACs that list I13.2 as a covered diagnosis.
Showing top 10 of 560 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I13.2.
4 Cigna
5 Medicare
CPT Codes Commonly Billed with I13.2
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 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
- 0077U CMS LCD: Billing and Coding: Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) CMS LCD
- 83880 CMS LCD: Billing and Coding: B-type Natriuretic Peptide (BNP) Testing 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
Convert I13.2 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I13.2 | 40403 | 10000 |
| I13.2 | 40413 | 10000 |
| I13.2 | 40493 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I13.2
Other codes in section I10-I1A (Hypertensive diseases).
ICD-10 I13.2, Billing FAQ
Is ICD-10 code I13.2 billable? +
Yes, I13.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I13.2 affect Medicare Advantage HCC risk adjustment? +
Yes. I13.2 maps to CMS-HCC v28 category 136. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I13.2 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 I13.2? +
Procedures frequently paired with I13.2 include: 93979, 93975, 93976, 93978, 93980.
What ICD-9 codes does I13.2 map to? +
Per CMS GEMs, I13.2 maps to ICD-9 codes: 40403, 40413, 40493. 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 May 31, 2026.
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