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Home Health & Hospice Week

Diagnosis Coding:

Avoid This Upcoding Trap With HTN Codes

Published on Fri Jan 06, 2012

You can capture case mix points with HTN codes in these circumstances. While the 401.1 and 401.9 hypertension codes no longer earn case mix points, there are still case mix points to be earned in the HTN category. The combination hypertension codes 402.x (Hypertensive heart disease), 403.x (Hypertensive renal disease) and 404.x (Hypertensive heart and renal disease) can earn case mix points under the home health prospective payment system. But these diagnoses must be validated by the physician or designee, cautions consultant Lynda Laff with Laff Associates in Hilton Head Island, S.C. Beware: Even though 401.0 (Malignant essential hypertension) remains case mix, its use should be rare in the home care setting, says attorney and coding expert Lisa Selman-Holman of Selman-Holman & Associates and CoDR -- Coding Done Right in Denton, Texas. Malignant hypertension is most often treated in the acute facility, although there are a few of these patients at [...]
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