AHA Coding Clinic
Subcategories in ICD-9-CM designated for systemic hypertension indicate the nature of hypertension, ie benign, malignant, or unspecified. Attributes of maliginant hypertension include rapidly rising blood pressure, usually in excess of 140 mm Hg diastolic with findings of visual impairement and symptoms or signs of progressive cardiac failure. If the patient does not receive adequate treatment , severe visual loss with hemorrhage, exudates and papilledema may ensue, and death may occure due to uremia, cardiac failure or cerberal hemorrhage The presence of papilledema with hypertension by definition is coded to malignant hypertension. Assign the fourth digit '9' when the physician does not document the primary or secondary hypertension as either benign or malignant. Educate the medical staff of the need for stating the hypertension as being either benign or malignant
