# Hypertensive crisis



## Arunbiot97 (Dec 20, 2016)

A 52 Year patient came to ED complaint of increasing blood pressure & dizziness. The patient is having the history of CKD who is under treatment. Nursing vital BP has 196/102. MD ordered the EKG, Chest X-ray & Blood work up. MD ordered to administrated IV HYDRALAZINE. After lab results MD diagnosed Hypertensive Emergency & CKD stage IV?

Kindly confirm whether I code I16.1,N18.4 alone OR I use HTN(I10-I15) codes along with these codes according to 2017 updates. I don't know it is Mandatory to code (I10-I15) along with I16 series code when documentation have only Increasing blood pressure and do not have hypertension


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## ancoleman22 (Dec 27, 2016)

Arunbiot97 said:


> A 52 Year patient came to ED complaint of increasing blood pressure & dizziness. The patient is having the history of CKD who is under treatment. Nursing vital BP has 196/102. MD ordered the EKG, Chest X-ray & Blood work up. MD ordered to administrated IV HYDRALAZINE. After lab results MD diagnosed Hypertensive Emergency & CKD stage IV?
> 
> Kindly confirm whether I code I16.1,N18.4 alone OR I use HTN(I10-I15) codes along with these codes according to 2017 updates. I don't know it is Mandatory to code (I10-I15) along with I16 series code when documentation have only Increasing blood pressure and do not have hypertension



I would only code the I16.1 and N18.4 unless the doctor is identifying a hypertensive disease as well. 

The note in my book states:
Code also:
Any identified hypertensive disease (I10-I15)

Since it states to code "Any* identified *hypertensive disease", if the disease is not identified I would not assume that they have one.


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## Ckemp0619 (Feb 1, 2017)

*Coding Clinic for Hypertensive Crisis*

There should be a new Coding Clinic for Hypertensive Crisis or Hypertensive Emergency with Hypertension. If the patient has a history of Hypertension and comes into the ER in Hypertensive Crisis then you would code both Hypertensive Crisis and the Hypertension. If there is no indication in the chart that the patient is on any medication for hypertension or has any history of hypertension then you would just code the Hypertensive Crisis.


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## Arunbiot97 (Feb 24, 2017)

*Thanks for your Head Up Kemp*

Thank You.



azdoobie said:


> There should be a new Coding Clinic for Hypertensive Crisis or Hypertensive Emergency with Hypertension. If the patient has a history of Hypertension and comes into the ER in Hypertensive Crisis then you would code both Hypertensive Crisis and the Hypertension. If there is no indication in the chart that the patient is on any medication for hypertension or has any history of hypertension then you would just code the Hypertensive Crisis.


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