Primary Care Coding Alert

Question: What is the difference between hypertension and pulmonary hypertension (HTN)? What is the correct way to code pulmonary HTN?

Ohio Subscriber

Answer: Systemic hypertension and pulmonary hypertension (PH) sound similar — and to a certain extent, they are. The word “hypertension” in both names means that pressure is high in the arteries, and the heart is working overtime to pump blood into them. The distinction? Where in the vasculature this high pressure exists. With systemic HTN, pressure is high in arteries throughout the body, whereas, in PH, there is high blood pressure in the pulmonary arteries, which carry oxygen-poor blood from the heart to the lungs.

A primary care practitioner is not as likely to diagnose PH (patients are usually referred to a specialist). However, if your provider does diagnose a patient with PH, or the condition is present and related to the reason for the encounter, report the category I27.- (Other pulmonary heart diseases) code that best aligns with the documentation:

• I27.0 (Primary pulmonary hypertension)
• I27.1 (Kyphoscoliotic heart disease)
• I27.20 (Pulmonary hypertension, unspecified)-I27.29 (Other secondary pulmonary hypertension)

Tip: “For secondary pulmonary hypertension (I27.1, I27.2-), code also any associated conditions or adverse effects of drugs or toxins. Remember, the sequencing is based on the reason for the encounter, except for adverse effects of drugs,” per ICD-10-CM guidelines.