Practice Management Alert

ICD-9 Changes You Need To Know About For Hypertensive Conditions

Heads up, billers: The new descriptors and fifth digits for coding hypertensive renal disease and hypertensive heart and renal disease diagnoses should make your ICD-9 coding more specific and easier than before.
 
In a nutshell: CMS revised the descriptors and fifth digits for ICD-9 codes in the 403.xx and 404.xx families.
 
403.xx ICD-9 Now Describes Kidney Disease

In the 403.xx series, CMS changed the descriptor -Hypertensive renal disease- to -Hypertensive kidney disease.-    Also, the fifth-digit -0- will represent -without chronic kidney disease,- while the fifth-digit -1- will describe -with chronic kidney disease.- The fifth digits in 403.xx formerly dealt with renal failure.

CMS Makes 3 Changes To 404.xx Fifth Digits

Further, CMS changed the 404.xx series code descriptor from -Hypertensive heart and renal disease- to -Hypertensive heart and kidney disease.- You should note the three revised fifth digits in 404.xx as well. The changes are:

 - 0 -quot; without heart failure or chronic kidney disease. The descriptor formerly read, -without mention of heart failure or renal failure.-
 - 2 -quot; with chronic kidney disease. CMS deleted the -with renal failure- definition.
 - 3 -quot; with heart failure and chronic kidney disease.
 
Effect: -These changes allow for [more] accurate diagnosis for patients suffering from hypertension associated with heart and renal disease,- says Tara Conklin, CPC, an independent coding consultant in Wesley Chapel, Fla.
 
Previously, you could use the hypertensive renal disease ICD-9 codes only for patients who had kidney failure, even though more patients have hypertension caused by chronic kidney insufficiency, she says.

Revisions Reduce Need For 401.x Codes

With these ICD-9 revisions, you no longer have to use a code from the 401.x series (Essential hypertension) in addition to a code from the 593.x series (Other disorders of kidney and ureter) when you-re coding a hypertension diagnosis caused by renal insufficiency, Conklin says.
 
Instead, you-ll need only one specific code.