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hypertension with Heart Failure

  1. Default hypertension with Heart Failure
    Medical Coding Books
    Please look into this scenario,

    A Patient that has benign hypertnsion with congestive heart failure is coded as
    a) 402.11, 428.0
    b) 404.11
    c) 401.1, 428.0
    d) 428.0, 402.11

    This question is in AAPC 2011 model question. AAPC anwer key states that option (a) is the correct answer. I do not agree with this, when no causal relationship has been established we should go with option (c). A clarification from an expert would be helpful.

  2. #2
    Columbia, MO
    Look in the coding guidelines from October 2010, with is now defined as meaning "due to" so it does indicate a causal relationship. answer A is correct.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Thanks Mitchell, still i have some reservations on that, here no casual relationship has been implied like 'due to' or 'hypertensive'. I wonder if you clarify my doubt.

  4. #4
    Columbia, MO
    The word with is now to be defined as indicating the causal relationship, the statement hypertension with CHF... the word with in that statement is to be interpreted as indicating a causal relationship.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Madison Wisconsin
    Default HTN with CHF
    Wouldn't it have to say benign hypertensive heart disease "with" CHF in order to code 402.11?
    Gina, CPC

  6. #6
    Columbia, MO
    no it says benign hypertension WITH CHF, the word with is inplace of the use of hypertensive. Hypertensive is an implied relationship and with or due to is a causal relationship either one is 402.xx

    Debra A. Mitchell, MSPH, CPC-H

  7. Default need help with htn and chf!!!!!
    In the patient chart it states as so: esssential hypertension, hypertensive heart disease and congestive heart failure.
    how do I code this out?
    all 3 codes separately, or just 402.90 and 428.0?

    Thank you

  8. Default
    The essential HTN gets combined into the main code for hypertensive heart disease


  9. Default
    yes, your correct it should be ans 'C' not 'A'.

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