Wiki 796.2 vs 401

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jharrell

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If a provider writes elevated or high blood pressure can someone please direct me somewhere in black and white maybe from CMS that it says to assign 796.2 and not 401.X. I know it says it on the guidelines but I am trying to find it somewhere on CMS because people are fighting me and want to code 401. Thanks for everyones help.

Jessica Harrell, CPC
 
I'm sure there isn't anything on the CMS website regarding this issue. I would check with your physician to find out his/her intent. HBP can caused my many things. If the physician is still trying to determine the cause of the HBP, then I would code 796.2. If the MD meant to diagnose hypertension, then go with 40x.x codes.
 
You can NOT code based on intent you can code based soely on the documentation. The coding guidelines is as good as it gets with respect to dx coding. If you look on the first page of the guidelines it states:
These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-9-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS.
ALSO:
Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA).
Sooooooo the guidelines tell us that HBP is to be coded as 796.2, that is good enough for anyone.
 
mitchellde said:
You can NOT code based on intent you can code based soely on the documentation. The coding guidelines is as good as it gets with respect to dx coding. If you look on the first page of the guidelines it states:
These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-9-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS.
ALSO:
Adherence to these guidelines when assigning ICD-9-CM diagnosis and procedure codes is required under the Health Insurance Portability and Accountability Act (HIPAA).
Sooooooo the guidelines tell us that HBP is to be coded as 796.2, that is good enough for anyone.
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I should have written more clearly. I did not intend to make it seem like you should code based on intent. What I meant was clarification of diagnosis might be required from the MD in order to make a decision. In the absence of such clarification, you have to use the words as written. In this case the words point you toward 796.2. My apologies for being unclear!
 
thanks guys for your help, I have never read that it said that in the beginning of the guidelines that is interesting.

Thanks,
Jessica Harrell, CPC
 
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