Question: Our physician recently diagnosed a patient with “white coat hypertension.” I want to know what this condition indicates and whether or not it is a covered diagnosis. If so, what codes will I have to use to report this diagnosis?
Nebraska Subscriber
Answer: Your clinician will diagnose a patient with white coat hypertension when he records high blood pressure readings in the doctor’s office, but normal readings in other settings. If your clinician diagnoses a patient with white-coat hypertension, you can report it with 796.2 (Elevated blood pressure reading without diagnosis of hypertension). Per ICD-9, 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. The ICD-9 index lists it under transient hypertension.
The ICD-10 equivalent to 796.2 is R03.0 (Elevated blood pressure reading, without diagnosis of hypertension).
For your clinician to arrive at a diagnosis of white-coat hypertension, he will have to record ambulatory blood pressure monitoring (ABPM) for a minimum period of 24 hours. You report one of the following codes for recording of the ABPM:
In addition to supplying 796.2 for Medicare patients, you also have to prove that the patient meets Medicare’s criteria for white-coat hypertension. According to Medicare Claims Processing Manual, Chapter 32, Section 10, a diagnosis of white coat hypertension should be suspected when a patient has all three of the following: