Primary Care Coding Alert

Question: We have a patient who was diagnosed with white coat hypertension. Is there an ICD-9 diagnosis for this? Idaho Subscriber Answer: Use 796.2 (Elevated blood pressure reading without diagnosis of hypertension) as your ICD-9 diagnosis. Remember that white coat hypertension (WCH) is diagnosed only when a patient has elevated BP in the clinic setting but otherwise has normal BP outside the office. According to Medicare's Internet Only Manual (IOM) Publication 100-04 Chapter 32 Section 10, WCH should be suspected when a patient has: 1. Clinic/office blood pressure >140/90 mm Hg on at least three separate clinic/office visits with two separate measurements made at each visit; 2. At least two documented separate blood pressure measurements taken outside the clinic/office that are < 140/90 mm Hg; and 3. No evidence of end-organ damage. To establish a diagnosis of white coat hypertension, the patient undergoes ambulatory blood pressure monitoring (ABPM). Medicare will [...]