What ICD (International Classification of Diseases) code is used for congestive heart failure (CHF) with hypertension (HTN) when prescribing Amlodipine, Lisinopril, Potassium chloride, Furosemide, Aldactone (Spironolactone), and Carvedilol?

ICD-10 Codes for CHF with Hypertension and Medication Assignment

For patients with congestive heart failure (CHF) and hypertension (HTN), the appropriate primary ICD-10 code is I11.0 (Hypertensive heart disease with heart failure).

This code specifically captures the combination of hypertension with heart failure, which is essential for proper documentation when prescribing the medications listed.

Primary and Secondary Diagnosis Codes

1. Primary code: I11.0 (Hypertensive heart disease with heart failure)

   • This code indicates that the heart failure is due to hypertension

2. Additional code:

   • Add a code from I50.- category to identify the type of heart failure:
     • I50.2 (Systolic heart failure)
     • I50.3 (Diastolic heart failure)
     • I50.4 (Combined systolic and diastolic heart failure)
     • I50.9 (Heart failure, unspecified) if type is not documented

3. For the common cold: J00 (Acute nasopharyngitis [common cold])

Medication Assignment to ICD Codes

Medication	Primary ICD Code	Rationale
Amlodipine	I11.0	Calcium channel blocker for hypertension management [1]
Lisinopril	I11.0	ACE inhibitor for both hypertension and heart failure [1]
Potassium chloride	I11.0	Supplement to prevent hypokalemia from diuretic therapy [1]
Furosemide	I11.0	Loop diuretic for fluid retention in heart failure [1]
Aldactone (Spironolactone)	I11.0	MRA for heart failure with reduced ejection fraction [1,2]
Carvedilol	I11.0	Beta-blocker for heart failure and hypertension [2,3]

Medication Regimen Rationale

This medication regimen follows guideline-directed medical therapy (GDMT) for patients with heart failure and hypertension:

• Amlodipine: Dihydropyridine calcium channel blocker for blood pressure control. Unlike non-dihydropyridine CCBs, it's safe in heart failure 1.

• Lisinopril: ACE inhibitor that reduces mortality and morbidity in heart failure while controlling blood pressure 1.

• Furosemide: Loop diuretic to manage fluid retention and congestion, a key component of heart failure management 1.

• Potassium chloride: Essential supplement when using furosemide to prevent hypokalemia 1.

• Spironolactone (Aldactone): Mineralocorticoid receptor antagonist that reduces mortality in heart failure patients, also helps manage potassium levels 1, 2.

• Carvedilol: Beta-blocker that improves survival in heart failure patients while also controlling blood pressure 2, 3.

Important Considerations

• Monitor serum potassium closely when using the combination of an ACE inhibitor (lisinopril), spironolactone, and potassium supplements, as hyperkalemia risk is increased 4.

• Carvedilol can accelerate elevation of serum potassium when used with spironolactone, furosemide, and ACE inhibitors 4.

• For patients with heart failure with preserved ejection fraction (HFpEF), the same ICD code applies, but medication strategy may differ slightly 1.

• If the patient has systolic heart failure (HFrEF), ensure all four pillars of therapy are included: ACE inhibitor/ARB, beta-blocker, MRA, and potentially an SGLT2 inhibitor 2.

• The common cold (J00) should be coded separately and would not affect the primary assignment of these heart failure and hypertension medications.