ICD-10-CM: Hypertension
TLDRIn this informative session, Terry Tropin, an experienced health information technology instructor and AHIMA-approved ICD-10 trainer, delves into the intricacies of ICD-10-CM coding for hypertension. Tropin outlines the importance of identifying whether hypertension is primary or secondary to other conditions and emphasizes the necessity of using the correct ICD-10 codes to reflect the sequence of conditions. He provides a detailed breakdown of various hypertension categories, from essential hypertension (I10) to hypertensive crises (I16) and pulmonary hypertension (I27), and explains how to document and code these conditions accurately. Tropin also addresses coding for hypertension in special circumstances, such as pregnancy and post-operative settings, and offers practical examples to enhance understanding. His expertise shines through as he navigates the complexities of ICD-10 coding, providing valuable insights and resources for healthcare professionals and students alike.
Takeaways
- 📚 Terry Tropin is a certified RHIA and CCSP with a Master's in Healthcare Administration Informatics and is an AHIMA-approved ICD-10 trainer with over 20 years of teaching experience.
- 📈 ICD-10-CM coding for hypertension requires determining if the hypertension is related to other conditions and which condition occurred first.
- 🚫 There are no separate codes for controlled or uncontrolled hypertension in ICD-10; instead, use the appropriate code from I10 to I15 categories.
- 🔍 For hypertension with related conditions, use codes from categories I11 to I13 or I1012 for pregnant patients, and I15 for secondary hypertension.
- 🧠 Different types of hypertension are coded differently, such as I10 for essential hypertension, I11 for hypertensive heart disease, I12 for hypertensive chronic kidney disease, and I16 for hypertensive crisis.
- 🤰 Hypertension in pregnancy is coded differently based on whether the patient had hypertension before pregnancy or developed it after becoming pregnant.
- 📌 It's crucial to read and understand the official ICD-10 coding guidelines for accurate coding, especially when dealing with hypertension-related conditions.
- 📈 Practice coding by turning off the video and attempting to code a given scenario, then check the answers to reinforce learning.
- 📚 Tropin's books on coding, available on Amazon, serve as study guides summarizing ICD-10 coding guidelines.
- 💡 Use additional codes to capture all relevant information, such as risk factors for hypertension, including exposure to environmental tobacco smoke and history of tobacco dependence.
- 📝 When coding for hypertension, consider the sequence of conditions and the reason for the patient's admission to accurately reflect the clinical picture.
Q & A
What are the qualifications and experience of Terry Tropin, the presenter of the lesson?
-Terry Tropin has a Master's in Healthcare Administration Informatics from the University of Maryland Global Campus and holds RHIA and CCSP certifications. He is an AHIMA-approved ICD-10 trainer with over 20 years of teaching health information technology at Montgomery College in Maryland. He has also authored books on coding, which are available on Amazon.
How does ICD-10-CM coding for hypertension differ from ICD-9-CM?
-In ICD-9-CM, there were separate codes to indicate controlled or uncontrolled hypertension. However, in ICD-10-CM, there are no separate codes for controlled or uncontrolled hypertension. Instead, the appropriate code from ICD categories I10 to I15 is used.
What is the correct ICD-10-CM code for a patient with essential hypertension and no other related conditions?
-The correct ICD-10-CM code for a patient with essential hypertension and no other related conditions is I10.
How is hypertensive heart disease coded in ICD-10-CM?
-Hypertensive heart disease is coded using the I11 category in ICD-10-CM. If heart failure is documented, an additional code is required to identify the type of heart failure.
What is the ICD-10-CM code for a patient with hypertension caused by chronic kidney disease?
-The ICD-10-CM code for a patient with hypertension caused by chronic kidney disease is I13, which indicates hypertension with both heart and kidney disease.
What are the categories for secondary hypertension in ICD-10-CM?
-Secondary hypertension in ICD-10-CM is coded under the I15 category. It includes conditions such as renal conditions, endocrine conditions, neurogenic conditions, aortic coarctation, pregnancy, or stress that cause hypertension.
How is hypertensive crisis reported in ICD-10-CM?
-Hypertensive crisis is reported using codes from the I16 category in ICD-10-CM, which includes I16.0 for hypertensive urgency, I16.1 for hypertensive emergency with organ damage, and I16.9 for hypertensive crisis unspecified.
What is the ICD-10-CM code for pulmonary hypertension?
-Pulmonary hypertension is coded under the I27 category in ICD-10-CM, with I27.0 for primary pulmonary hypertension, I27.1 for scoliosis-related heart disease, and I27.2 for other secondary pulmonary hypertension.
How is post-operative or post-procedural hypertension coded in ICD-10-CM?
-Post-operative or post-procedural hypertension is coded using I97.3 in ICD-10-CM. It must be clearly documented as due to the procedure.
What is the ICD-10-CM code for transient hypertension?
-Transient hypertension is coded as R03.0 in ICD-10-CM. It is defined as a blood pressure spike over 150/99 mmHg that later decreases.
How can one ensure they are coding hypertension correctly according to the guidelines?
-To ensure correct coding of hypertension, one should read and understand the official ICD-10 coding guidelines, make notes in the coding books, underline subterms, and circle 'use additional code' notes. It's also important to consider the whole patient story and sequence codes based on the reason for the encounter or admission.
Outlines
📚 Introduction to ICD-10-CM Coding for Hypertension
The speaker, Terry Tropin, introduces himself as a healthcare administration informatics expert with certifications in RHIA and CCSP. He is an approved ICD-10 trainer with over 20 years of teaching experience at Montgomery College, Maryland. Tropin has authored books on coding, available on Amazon, which summarize ICD-10 coding guidelines. The lesson focuses on selecting the correct ICD-10-CM code for hypertension, considering whether the patient has other related conditions, the sequence of hypertension and related conditions, the type of hypertension, and additional coding requirements. He emphasizes that ICD-10 does not have separate codes for controlled or uncontrolled hypertension and explains the importance of determining which condition came first, hypertension or a related condition.
🖥️ ICD-10 Coding Guidelines for Hypertensive Heart and Kidney Disease
Tropin discusses the ICD-10 coding guidelines for hypertensive heart disease (I11) and hypertensive chronic kidney disease (I12). He explains the use of additional codes to identify the type of heart failure and the relationship between hypertension and heart disease. The speaker also covers the coding for patients with both heart and kidney diseases (I13) and the importance of using the correct ICD-10 codes to reflect the sequence of conditions. He provides a practice example of a patient with systemic hypertension and polycystic kidney disease, emphasizing the need to code for both conditions separately since they are not related.
📈 Secondary Hypertension and Hypertensive Crisis
This section focuses on secondary hypertension (I15), where another condition causes the hypertension. Tropin lists examples of conditions that can lead to secondary hypertension, such as renal, endocrine, and neurogenic conditions. He explains the coding process for patients with secondary hypertension, including the need to code for both the hypertension and the underlying condition causing it. The speaker also discusses hypertensive crisis (I16), a severe increase in blood pressure that can lead to stroke, and provides a practice example for coding secondary hypertension due to periarteritis nodosa.
💡 Pulmonary Hypertension and Post-Procedural Hypertension
Tropin covers pulmonary hypertension (I27), which is high blood pressure in the lungs, and its distinction from systemic hypertension. He explains the difference between primary pulmonary hypertension and secondary pulmonary hypertension and the importance of coding for associated conditions. The speaker also discusses post-operative or post-procedural hypertension (I97.3), emphasizing that the hypertension must be clearly documented as due to the procedure. He provides guidance on how to code for transient hypertension (R03.3) when a patient experiences a spike in blood pressure that is not yet confirmed as hypertension.
📝 Additional Hypertension-Related Coding Considerations
The final paragraph addresses specific rules for coding conditions associated with hypertension, such as hypertensive retinopathy, hypertensive cerebral vascular disease, and hypertension in pregnancy. Tropin explains the need to use two codes for hypertensive retinopathy and the importance of sequencing the codes correctly based on the reason for admission. He also discusses the coding for hypertension in pregnancy, highlighting the difference between pre-existing hypertension and gestational hypertension. The speaker encourages participants to mark their books and use notes to easily find guidelines and emphasizes the importance of reading notes and considering the whole story when coding.
Mindmap
Keywords
💡ICD-10-CM Coding
💡Hypertension
💡Health Information Technology
💡RHIA and CCSP Certification
💡Montgomery College
💡Coding Guidelines
💡Primary Hypertension
💡Secondary Hypertension
💡Hypertensive Crisis
💡Pulmonary Hypertension
💡Post-operative Hypertension
Highlights
The lesson is about ICD-10-CM coding for hypertension, presented by Terry Tropin, an experienced educator and author in the field.
Terry Tropin has a Master's in Healthcare Administration Informatics and is an AHIMA approved ICD-10 trainer.
The presenter has taught health information technology for over 20 years and has written books on coding.
There are no separate codes for controlled or uncontrolled hypertension in ICD-10-CM; instead, use the appropriate code from I10 to I15 categories.
For hypertension with related conditions, it's essential to determine which condition came first to select the correct ICD-10-CM code.
Essential hypertension is coded as I10, used when there are no other related conditions.
Hypertensive heart disease is categorized under I11, indicating that hypertension came first and caused the heart disease.
Hypertensive chronic kidney disease is coded under I12, showing a cause-and-effect relationship between hypertension and kidney disease.
Secondary hypertension is coded under I15, where another condition caused the hypertension.
Hypertensive crisis is categorized under I16, representing a severe increase in blood pressure that can lead to organ damage.
Pulmonary hypertension, high blood pressure in the lungs, is coded under I27 and can be primary or secondary.
Post-operative or post-procedural hypertension is coded as I97.3, and it must be clearly documented as due to the procedure.
Transient hypertension is coded as R03.3, used when a patient has a spike in blood pressure that is not yet confirmed as hypertension.
Risk factors for hypertension, such as exposure to environmental tobacco smoke and history of tobacco dependence, should also be coded.
Specific rules in ICD-10-CM coding apply to conditions like hypertensive retinopathy, hypertensive cerebral vascular disease, and hypertension in pregnancy.
For patients with hypertension and chronic kidney disease stage five, the codes are I12.0 and N18.6, with an additional code for dialysis if applicable.
The presenter emphasizes the importance of reading ICD-10 coding guidelines thoroughly and making notes for quick reference.
Transcripts
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