Cardiology Coding Alert

This new monthly features helps you prepare for the transition from ICD-9 to ICD-10.

ICD-9 2011 and ICD-10 2011 both have coding options for essential hypertension, but you won't find a one-toone correspondence between them.

ICD-9: ICD-9 2011 includes three coding options for essential hypertension:

• 401.0 -- Essential hypertension; malignant
• 401.1 -- ... benign
• 401.9 -- ... unspecified.

ICD-10: ICD-10 2011 includes only one code, solving the age-old problem of having to choose the unspecified code when documentation fails to indicate benign or malignant. The ICD-10 code is the letter I followed by the number 10:

• I10 -- Essential (primary) hypertension.

What's new: When ICD-10 goes into effect, you will need to keep an eye on documentation for tobacco exposure. ICD-10 includes an instruction to "Use additional code to identify:"

• Exposure to environmental tobacco smoke (Z77.22)
• History of tobacco use (Z87.891)
• Occupational exposure to environmental tobacco smoke (Z57.31)
• Tobacco dependence (F17.-)
• Tobacco use (Z72.0).

What stays the same: Both the ICD-9 and ICD-10 entries state the codes include "high blood pressure," but you have separate codes in both sets for when the cardiologist documents an elevated reading without diagnosing hypertension:

ICD-9: 796.2 -- Elevated blood-pressure reading, without diagnosis of hypertension

ICD-10: R03.0 -- Elevated blood-pressure reading, without diagnosis of hypertension.

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the codes and official guidelines in effect at that time (or more specifically, always use the codes and guidelines effective for the relevant date of service). Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.