Hypertention Malignant verus Benign


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Hypertension Coding

Benign hypertension is Essential hypertension that runs a relatively long and symptomless course.

Malignant hypertension is characterized by rapidly rising blood pressure, usually in excess of 140 mm Hg diastolic with findings of visual impairment and symptoms or signs of progressive cardiac failure.

ICD-9 official guidelines offer a key rule for compliant HTN coding. When reporting codes from 401.x, you must choose a fourth digit to complete the code: "malignant (.0), benign (.1), or unspecified (.9). Do not use either .0 malignant or .1 benign unless medical record documentation supports such a designation."

That guideline means that if the physician documents only "hypertension" as the diagnosis (without stating benign or malignant), your only compliant choice is 401.9 (Essential hypertension; unspecified). Although benign HTN is far more common than malignant HTN, you shouldn’t assume any patient’s HTN is benign when you choose your code.

also go through:- http://blogs.hcpro.com/icd-10/2010/03/hypertension-codes/
Last edited:


True Blue
Columbia, MO
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exactly what I was going to say. The diagnosis of malignant vs benign is completely up to the provider and will be based on many factors. It is not the coders discretion to add up symptoms and lab values and determine the diagnosis. Therefore for hypertension as Dr Dmello points out will be unspecified unless documented as benign or malignant.
ICD-10 CM however at this time does not have codes for benign or malignant or unspecified, the code is I10 and is hypertension.