Home Health ICD-9/ICD-10 Alert
Watch Hypertension Assumptions
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Question: When we are coding for patients with hypertension (HTN), congestive heart failure (CHF), and renal failure, we often receive no physician indication that the heart disease is due to the HTN. When this is the case, we use the 403.x (Hypertensive chronic kidney disease) code. We also always add the additional code for stage of the renal disease. Do we need to add a CHF code as well? -- Michigan Subscriber Answer: It is a mistake to code hypertensive heart failure when there is no physician documentation to indicate that the heart disease is related to the hypertension, so you shouldn't use the 402.x (Hypertensive heart disease) code. Unlike with hypertensive heart disease, you can assume hypertensive chronic kidney disease when the patient has both hypertension and chronic kidney disease (CKD). In this case, list 403.xx and a code from the 585 (Chronic kidney disease [CKD]) category as well as CHF. If the patient has CHF, you must code for it -- where you sequence it depends on the focus of care.
Home Health ICD-9/ICD-10 Alert
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