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DEFINITION: Elevated blood pressure above the normal to a period of time is known as hypertension

NORMAL BLOOD PRESSURE:According to recent studies 140/90 based on people life style, environment.

Mainly classified into two typesI. PRIMARY HYPERTENSION:It is also known

as essential hypertension.CAUSES:unknown.

2. SECONDARY HYPERTENSION:identifiable cause like:kidney diseases,hyperthyroidism,hypothyroidism

obesity etc.

1.Kideney disease 2.Hyper thyroidism3.Hypo thyroidism4.Alcohol consumption5.Smoking6.Obesity7.High consumption of salt in food.

ISCHEMIC HEART DISEASES STROKES PERIPHERAL VASCULAR DISEASE HEART FAILURE AORTIC ANEURYSMS ATEROSCLEROSIS PULMONARY EMBOLISM CKD

PHARMACOLOGICAL TREATMENT:Examples CALCIUM CHANNEL BLOCKERS:

verapamil,diltiazem,cilnidipine,felodipine.MOA:acts by inhibitng the calcium channels

Beta-blockers:metaprolol,propranolol,atenolol.MOA:acts by blocking the b receptors.

ACE INHIBITORS:examples:captopril,enalapril.MOA:acts by blocking angiotensin converting enzyme.

THIAZIDE DIURETICS:examples Chlorthalidone,hydrochlorthiazide. MOA:acts by inhibiting the re absorption

of sodium and calcium. ANGIOTENSIN RECEPTOR BLOCKERS: Telmisartan, irbesartan. MOA:acts by blocking angiotensin

receptors.

LIFE STYLE MODIFICATION DIET MODIFICATION AVOIDING ALCOHOL CONSUMPTION AVOIDING SMOKING EXERCISE

Hypertension: ICD-10-CM for 2017 provides specific codes for hypertensive urgency and emergency, which are both considered hypertension crises. In the switch to ICD-10-CM, hypertension stopped being classified as malignant, benign, or unspecified, as it was in ICD-9-CM, and the terms “emergency” and “urgency” disappeared. The update for 2017 adds these two terms back in and goes one step further by having specific codes for the concepts.

I16.0 Hypertensive urgency I16.1 Hypertensive emergency I16.9 Hypertensive crisis, unspecified

Both I16.1 (Hypertensive emergency) and I16.9 (Hypertensive crisis, unspecified) classify to a complication or comorbidity (CC) and, interestingly, do not have any excludes notes for use with other codes.

Correct coding now depends on knowing what constitutes an urgent versus an emergent case of hypertension:

Hypertensive urgency is characterized by systolic blood pressure (SBP) greater than 180 mm Hg or diastolic blood pressure (DBP) greater than 110 mm Hg with symptoms such as headache, dyspnea, or chest pain but without end-organ involvement. Hypertensive emergency is distinguished by SBP greater than 180 mm Hg or DBP greater than 120 mm Hg with end-organ involvement such as neurologic, renal, or cardiac systems

Emergency: Blood pressure reaches levels indicating impending or progressive organ damage. Such levels usually exceed 180 systolic and 120 dystolic, but could be lower in patients without previous high blood pressure. The patient is at risk for stroke, loss of consciousness, memory loss, acute myocardial infarction or angina, aortic dissection, damage to the eyes and kidneys, and pulmonary edema. For pregnant patients, a hypertensive emergency could lead to eclampsia.

“urgent” (no severity impact) “crisis” (having severity impact)

An additional code should be used to code an identified hypertensive disease with the sequencing then based on the circumstances of the admission.  

If the provider’s documentation doesn’t specify urgency or emergency, you’ll report the unspecified code.

Dr. Santosh Kumar GupthaTrainer/Author CCS-P, CCS , CPC, COC, CIC, CPC-P, CRC,

CCC, CPCO, CANPC, CPB, CPMA, CEMC, CEDC, CIMC, CFPC, CUC, COBGC, CPCD, COSC, CPRC, CPEDC, CHONC, CENTC, CRHC, CGIC, CASCC, CGSC, CSFAC, CCVTC, RMC, RMA, CMBS, CMRS, CSCS, CSBB, FCR, FNR, FOR, CHA, CHL7, AHIMA Approved ICD-10 Trainer, AHIMA ICD-10 Ambassador http://www.medesunglobal.com

For more details of Medical Coding Training Visit Medesun Global Website.