ED Coding and Reimbursement Alert

Here’s the code to use for essential hypertension.

When patients are suffering from a hypertensive disease, selecting a diagnosis isn’t just a matter of choosing from a code or two to upload to your claim.

There are several different types of hypertensive disease represented in the ICD-10 code book. Further, you’ll typically need to code to the 4^th — or in some cases, 5^th — character on these diagnoses. These 4^th and 5^th characters vary depending on the type of hypertensive disease the patient has.

Read on for information on diagnosis coding for hypertensive diseases.

Mark Essential Hypertension With I10

The first code in the “Hypertensive diseases (I10-I1A)” set is for hypertension. Not only is hypertension one of the most common ED diagnoses, it’s also one of the simplest: I10 (Essential (primary) hypertension). This is one of the few codes in the set that doesn’t require a 4^th or 5^th character.

Next is hypertensive heart disease, which you’ll report with an I11.- (Hypertensive heart disease) code.

4^th character: Use the 4^th character in these diagnoses to denote with (0) or without (9) heart failure.

From there, the code set goes to I12.- (Hypertensive chronic kidney disease).

4^th character: Use the 4^th character to mark the stage of the chronic kidney disease (CKD): with stage 5 chronic kidney disease or end stage renal disease (0) or with stage 1 through 4 CKD, or unspecified CKD (9).

Use 5 Characters With These Hypertensive Diseases

If a patient is suffering from hypertensive heart/kidney disease, you’ll report a code from the I13.- (Hypertensive heart and chronic kidney disease) set.

4^th character: There are a pair of four-character codes in this set: I13.0 (Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease) and I13.2 (Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease).

5^th character: There are also a pair of five-character codes in this set: I13.10 (Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease) and I13.11 (Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease).

Secondary Hypertension Has Several Sub-Diagnoses

When a patient suffers from secondary hypertension, you’ll choose a code from the I15.- (Secondary hypertension) code set.

4^th character: Unlike other fourth character options in this code family, these codes all have different descriptors. The codes are:

• I15.0 (Renovascular hypertension)
• I15.1 (Hypertension secondary to other renal disorders)
• I15.2 (Hypertension secondary to endocrine disorders)
• I15.8 (Other secondary hypertension)
• I15.9 (Secondary hypertension, unspecified)

Know Urgency, Emergency Definitions for Easier Coding

When a patient is in hypertensive crisis, you’ll report a code from I16.- (Hypertensive crisis).

4^th character: The 4^th character in this option denotes the stage of the crisis. Here’s a look at your options:

• I16.0 (Hypertensive urgency)

Urgency is a “severe increase in blood pressure without corresponding organ damage,” according to ICD-10.

• I16.1 (Hypertensive emergency)

Emergency is “a severe increase in blood pressure with corresponding organ damage,” according to ICD-10.

• I16.9 (Hypertensive crisis, unspecified)

The final option in the hypertensive diseases is I1A.- (Other hypertension).

4^th character: There’s only one 4^th-character option in I1A.-: I1A.0 (Resistant hypertension).