October 2016 ICD-10 Code Update: New Hypertension Codes Released
New hypertension codes for hypertensive urgency (I16.0), hypertensive emergency (I16.1), and hypertensive crisis, unspecified (I16.9) went into effect for discharges starting October 1st. According to Coding Clinic, “The American Academy of Pediatrics requested detailed codes to track patients who present with clinically significant hypertension that requires immediate treatment.” Accelerated or malignant hypertension will continue to be assigned code I10, Essential (primary) hypertension.
Hypertensive crisis (CC) – I16.9
- Severe increase in blood pressure that can lead to organ damage (e.g. stroke)
- Systolic pressure of 180 mmHg or higher
- Diastolic pressure of 120 mmHG or higher
- Divided into two categories: urgency and emergency
Hypertensive urgency – I16.0
- Severe hypertension, usually a diastolic blood pressure above 120 mmHg in asymptomatic patients
- No evidence of acute end-organ damage and are at little short term risk
- Can experience severe headache, shortness of breath, nosebleeds, severe anxiety
Hypertensive emergency (CC) –
- Severe hypertension, usually a diastolic blood pressure above 120 mmHg with evidence of acute end-organ damage
- A hypertensive emergency can be life threatening and requires immediate treatment, usually with parenteral medications in a monitored setting
- Can present with stroke, loss of consciousness, memory loss, heart attack, damage to eyes and kidneys, loss of kidney function, aortic dissection, angina, pulmonary edema, eclampsia
It is interesting to note that the more general condition ‘hypertensive crisis’ is designated as a CC. Even though hypertensive crisis, unspecified is a CC, best practice would be to request further clarification of whether a patient has ‘hypertensive urgency’ or ‘emergency’ when ‘hypertensive crisis’ is documented.