Cardiology Coding Alert

Question: Per the medical documentation, my cardiologist diagnosed a patient with pulmonary hypertension. I was wondering if I can assume that the patient also has essential hypertension by default? So should I report I10 (Essential (primary) hypertension) also include the code for pulmonary hypertension?

Hawaii Subscriber

Answer: No. Since pulmonary and essential hypertension have different etiologies, you should never assume a connection between them.

Pulmonary hypertension, which occurs when there is high pressure in the artery leading from the heart to the lungs, is generally due to other conditions such as coronary heart disease and other congenital heart conditions, chronic lung diseases, and connective tissue disease. Essential, or primary, hypertension, also known as high blood pressure, is a more common condition caused by such lifestyle choices as smoking, excessive alcohol consumption, and obesity.

So, unless your cardiologist has documented the existence of the two conditions, you should not automatically report I10 with I27.0 (Primary pulmonary hypertension). The two are separate diagnoses, and you should only report both if they are medically relevant to a patient visit.