ED Coding and Reimbursement Alert

Reader Questions:

Keep Same HTN Code for Uncontrolled/Controlled

Question:Does ICD-9 distinguish controlled and uncontrolled hypertension (HTN)?Missouri SubscriberAnswer: No. Section I.C.7.a of the ICD-9 official guidelines indicates that you should assign a code from 401.x-405.x (Hypertensive disease) for both controlled and uncontrolled hypertension (guidelines available at www.cdc.gov/nchs/data/icd9/icdguide09.pdf).Controlled hypertension "usually refers to an existing state of hypertension under control by therapy," the guidelines state. "Uncontrolled hypertension may refer to untreated hypertension or hypertension not responding to current therapeutic regimen."Caution: Don't confuse "uncontrolled" with "malignant" hypertension, which refers to severely elevated blood pressure. To use a malignant hypertension diagnosis code, such as 401.0 (Essential hypertension; malignant), your physician's documentation must specifically support your choice of a "malignant" code.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All