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Diagnosis code of Hypertension

  1. Smile Diagnosis code of Hypertension
    Medical Coding Books
    Hi:

    Can anyone clarify the criteria for coding 405.99(Other unspecified secondary hypertension), and also let me know whether both 401.9 & 405.99 could be coded/billed together for the same patient on same date of service,

    Thanks in advance...

    With Regards,
    Dr.Jemimah, CPC

  2. Default
    Hi,

    If the document states only secondary hypertension, you can add 405.99 since the reason for HTN not stated. And the Hypertension is documented as secondary that is specific than Hypertension NOS. So we can code only 405.99 since that is more specific.

    Hope it helps!

    Thara L CPC H

  3. Smile Diagnosis code for hypertension
    Thanks for yr help Thara, so thus I understand that dx 405.99 can be coded alone if the document clearly reports as "secondary hypertension" but would you pls also confirm whether both 401.9 & 405.99 could be coded/billed together or not...

  4. #4
    Location
    Columbia, MO
    Posts
    12,867
    Default
    let me try to explain further:
    401 is a category for essential hypertension - persistently high arterial blood pressure , - meaning above 140mm Hg systolic and 90 mm Hg diastolic; and without a discoverable cause. If the provider does not indicate benign or malignant in the documentation then it is coded as unspecified. - 401.9
    405 is a category for secondary hypertension - elevated arterial blood pressure due to various primary diseases, - if it is not specified by the provider to be benign or malignant then it is coded as unspecified, and must be document as being due to renovascular disease or other disease. 405.91 or 405.99
    You cannot code both 401.9 and 405.99
    401.0 - 401.9 will be I10 in ICD-10
    405 codes will be I18 codes in ICD-10.
    Hopefully this will provide some assistance

    Debra A. Mitchell, MSPH, CPC-H

  5. Smile Diagnosis code for hypertension
    Thanks a lot for your detailed explanations and assistance....

  6. #6
    Location
    Virginia Beach
    Posts
    28
    Default HTN and Secondary HTN
    I was also confused on this and the response given was very helpful. However, I have another scenario that I hope you can also help with. If the patient has secondary HTN in PMH and has Hypertensive Heart disease in the Assessment, would you just code the Hypertensive Heart disease only and not list the secondary HTN found in PMH even if there is a med in the chart to make it current? Thank you in advance for any assistance you may provide.

  7. #7
    Default
    I'd code it as well as it's secondary to Hypertensive Heart Disease.

    But the Hypertensive Heart Disease is the primary Dx.
    Last edited by BenCrocker; 01-13-2015 at 11:31 AM. Reason: Added info.

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