Cardiology Coding Alert

But beware of choosing this code when the diagnosis is NOS.

The one-to-one crosswalk from ICD-9 to ICD-10 keeps primary pulmonary hypertension coding fairly simple. You may be surprised by the Excludes1 note with the ICD-10 code, though.

ICD-9-CM Code

• 416.0, Primary pulmonary hypertension

ICD-10-CM Code

• I27.0, Primary pulmonary hypertension

Pulmonary hypertension is high blood pressure affecting arteries in the lungs. The condition also affects the heart, which eventually weakens and fails as the right ventricle works harder to pump blood through the lungs.

ICD-9 coding rules: Code 416.0 applied to “Idiopathic pulmonary arteriosclerosis” and “Pulmonary hypertension (essential) (idiopathic) (primary),” according to a list with the code.

Code 416.0 excluded pulmonary hypertension NOS and secondary pulmonary hypertension, which you reported using 416.8 (Other chronic pulmonary heart diseases).

ICD-10 changes: ICD-10 indexes “Arteriosclerosis, pulmonary (idiopathic)” to I27.0. Similarly, the index points to I27.0 for the entry “Hypertension, pulmonary, primary (idiopathic).”

Code I27.0 has an Excludes1 note listing pulmonary hypertension NOS and secondary pulmonary hypertension. Note that you should report both secondary and NOS diagnoses using the secondary code I27.2 (Other secondary pulmonary hypertension).

Documentation: The cardiologist should document primary or idiopathic to help support the choice of I27.0. 

Coder tips: “Other” code 416.8 crosses to both I27.89 (Other specified pulmonary heart diseases) and secondary hypertension code I27.2. If you report I27.2, you also should code the underlying condition.

Remember: Oct. 1, 2015, was the implementation date for ICD-10. You should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update .