Cardiology Coding Alert

Question: Should I report both essential hypertension and pulmonary hypertension together? Or should I code only the pulmonary hypertension because it's more specific?

Tennessee Subscriber

Answer: Assuming the essential hypertension you reference is general high arterial blood pressure (not pulmonary), essential and pulmonary hypertension are separate diagnoses. So if the cardiologist documents both diagnoses as medically relevant to the visit, you should report both.

For essential hypertension, use 401.x (Essential hypertension).

Essential hypertension, also called primary or idiopathic, means the high arterial blood pressure occurs without any identifiable organic cause.

Pulmonary hypertension is high blood pressure in the arteries that supply the lungs. For pulmonary hypertension, choose the code your documentation supports from 415.x (Acute pulmonary heart disease) or 416.x (Chronic pulmonary heart disease).

Note that physicians may refer to "essential" pulmonary hypertension, coded to 416.0 (Primary pulmonary hypertension). So be sure to verify the diagnosis before you code.