# white coat syndrome with htn dx



## sguzman1 (Jun 21, 2014)

hello,


My doctor has a habit of dx white coat syndrome with a dx of htn w/ ckd, can i code the 796.2 along with the 403.90 585.x ? thank you


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## mitchellde (Jun 21, 2014)

No you cannot code the elevated BP with an HTN dx code.  The description of 796.2 states without a diagnosis of hypertension.  Also the code has a note that states
"Note
This category is to be used to record an episode of elevated blood pressure in a patient in whom no formal diagnosis of hypertension has been made, or as an incidental finding."


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## ValerieBatesHoffCPCCPMA (Jun 27, 2014)

I agree with Debra, ICD9 guidelines state there is an assumed a relationship between HTN & CKD.  

White coat syndrome - the stress of being in the doctors office causes temporary increase in blood pressure. One elevated reading does not constitute a diagnosis of hypertension.

Here are some ICD9 guidelines:

Hypertension, Transient 

Assign code 796.2, Elevated blood pressure reading without diagnosis of hypertension, unless patient has an established diagnosis of hypertension. Assign code 642.3x for transient hypertension of pregnancy.

ICD-9-CM Official Guidelines for Coding and Reporting Effective October 1, 2011 Page 38 of 107

Hypertensive Chronic Kidney Disease 

Assign codes from category 403, Hypertensive chronic kidney disease, when conditions classified to category 585 or code 587 are present with hypertension.

ICD-9-CM Official Guidelines for Coding and Reporting Effective October 1, 2011 Page 36 of 107

From a medical perspective hypertension/diabetes usually causes chronic kidney disease. The treatment of CKD consists of getting control of the disease causing the kidney damage. You might want to query your physician as to what is the true underlying cause. If there has not been a definitive diagnosis of HTN then Hypertensive chronic kidney disease should not be reported. 


http://kidney.niddk.nih.gov/kudiseases/pubs/highblood/


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