2026 ICD-10-CM Diagnosis Code I12.0Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
ICD-10-CM Codes›I00–I99›I10-I1A›I12
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 326
- Chronic Condition
I12.0 is a billable ICD-10-CM diagnosis code for hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 8, 19, 673 through 675, 682 through 684. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 27 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chronic kidney disease and Hypertension with complications and secondary hypertension.
For Medicare Advantage risk adjustment, I12.0 maps to CMS-HCC Category 326 (Chronic Kidney Disease, Stage 5) under the V28 model, adding a risk factor of about 0.815 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
I12.0 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Chronic kidney disease due to benign hypertension
- Chronic kidney disease stage 5 due to benign hypertension
- Chronic kidney disease stage 5 due to hypertension
- End stage renal disease due to benign hypertension
- End stage renal disease due to hypertension
- End stage renal disease on dialysis due to hypertension
- End stage renal disease on dialysis due to type 2 diabetes mellitus
- End stage renal failure on dialysis
- Hypertension concurrent and due to end stage renal disease on dialysis
- Hypertension concurrent and due to end stage renal disease on dialysis due to type 2 diabetes mellitus
- Hypertension in chronic kidney disease due to type 2 diabetes mellitus
- Hypertensive renal failure
- Malignant hypertensive chronic kidney disease
- Malignant hypertensive chronic kidney disease stage 5
- Malignant hypertensive end stage renal disease
- Malignant hypertensive end stage renal disease on dialysis
- Malignant hypertensive renal disease
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Use Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
due to hypertension I12.0
renal (functional) (pelvis) See Also: Disease, kidney; N28.9
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Chronic Kidney Disease
You have two kidneys, each about the size of your fist. Their main job is to filter your blood. They remove wastes and extra water, which become urine. They also keep the body's chemicals balanced, help control blood pressure, and make hormones.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert I12.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About I12.0Overview
Is I12.0 (Hypertensive chronic kidney disease) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does I12.0 group to?
When hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease is the principal diagnosis on an inpatient stay, it groups to MS-DRG 8, 19, 673, 674, 675, 682, 683, 684, with relative weights from 0.6003 to 6.6272 depending on complications. Higher weights mean higher Medicare reimbursement.
Is I12.0 a CC or MCC?
CMS lists I12.0 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 27 closely related codes in its exclusion list.
What is the ICD-9 equivalent of I12.0?
Under the General Equivalence Mappings, hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease converts to ICD-9-CM 403.01 (mal hyp kid w cr kid V), 403.11 (ben hyp kid w cr kid V), and 403.91 (hyp kid NOS w cr kid V). The mapping is approximate, so confirm the match fits the documentation.
What HCC is I12.0?
I12.0 (hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease) maps to CMS-HCC Category 326 (Chronic Kidney Disease, Stage 5), commonly written as HCC 326, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 136 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 262.
Does I12.0 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I12.0 adds a risk adjustment factor of about 0.815 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.815 to 1.050 depending on the payment segment). HCC 326 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 326 category page.
