get the scoop on pulmonary hypertension coding

7/21/2019 Get the Scoop on Pulmonary Hypertension Coding

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Get the Scoop on Pulmonary Hypertension Coding

By Susan Dooley

Pulmonary hypertension, also called pulmonary arterial hypertension, or PAH, differs from the

hypertension we’re used to talking about.

Learn the Difference: Systemic Versus Pulmonary

Hypertension

Hypertension is high blood pressure all over the body, often also called arterial, primary, or systemic

hypertension, all of which are synonyms in the ICD-10-CM diagnosis code I10 (Essential [primary]

hypertension). When clinicians measure the blood pressure in your arm with a sphygmomanometer,

they’re screening for systemic hypertension. By the way, while ICD-9-CM called for differentiationbetween benign or malignant hypertension, ICD-10-CM does not use those concepts.

Pulmonary hypertension, however, is high blood pressure in the arteries supplying the lungs. According

to the American Heart Association, pulmonary hypertension refers to high blood pressure in the arteries

of the lungs, occurring when the vessels of the pulmonary arterial system constrict and their walls

thicken. As a result, blood pressure builds. The right side of the heart pumps deoxygenated blood into

the lungs, and when the lungs’ arteries thicken and are unable to accommodate the blood volumes

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being pumped to the lungs for oxygenation, the right ventricle works harder and harder. Arrhythmias

can develop and the right ventricle can fail.

Reporting Pulmonary Hypertension

For primary pulmonary hypertension, you’ll report I27.0 (Primary pulmonary hypertension). Primary

pulmonary hypertension, also called idiopathic pulmonary arterial hypertension (IPAH), is relatively rare,

characterized by elevated pulmonary artery pressure without an apparent cause. To be able to reportthis condition, your physician, physician’s assistant, or nurse practitioner must document primary or

idiopathic pulmonary hypertension. Note that I27.0 carries an Excludes1 note listing pulmonary

hypertension NOS and secondary pulmonary hypertension.

To report secondary and NOS diagnoses, use the secondary code I27.2 (Other secondary pulmonary

hypertension). Secondary pulmonary hypertension can be caused by conditions such as pulmonary

emboli, emphysema, and connective tissue diseases.

Will ICD-10-CM 2017 Expand Pulmonary HypertensionCode Offerings?

Bayer HealthCare Pharmaceuticals recently requested a group of new codes for pulmonary hypertension

that it said coincides with the way clinicians actually classify the disease. The World Health Organization

created this system of five diagnostic groups in 2009. WHO Group I covers pulmonary arterial

hypertension, Group II encompasses pulmonary hypertension caused by left heart disease, and Group III

includes pulmonary hypertension caused by lung disease and/or hypoxia. Group IV covers chronic

thromboembolic pulmonary hypertension, and Group V, pulmonary hypertension with unclear

multifactorial mechanisms. The ICD-10 Coordination and Maintenance Committee promised to seek

input from relevant medical societies before adding more codes to the ICD-10 code set.

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get the scoop on pulmonary hypertension coding

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