The Complete Diagnosis Coding Book by Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA Chapter 4 Coding Circulatory Conditions Copyright © 2009 by The McGraw-Hill.

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The Complete Diagnosis Coding Book by Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA Chapter 4 Coding Circulatory Conditions Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved McGraw Hill/Irwin

Introduction ·Circulatory conditions, such as hypertension, are systemic. They affect the entire body. ·Circulatory conditions are almost always coded

Hypotension Patient’s blood pressure is lower than normal: ·Can cause a lack of oxygen ·Common symptoms: lightheadedness and dizziness 4 - 3

Hypertension Patient’s blood pressure is consistently too high: ·Can cause damage to organs, especially heart and kidneys ·Must be specifically diagnosed by the physician 4 - 4

Elevated Blood Pressure A temporary or occasional increase in the patient’s blood pressure: ·May be caused by nervousness, caffeine, or stress 4 - 5

Hypertension ·Hypertension may be uncontrolled or controlled. ·Controlled hypertension is successfully being treated. ·Either diagnosis does not affect the code assignment

Hypertension Malignant: Very unusual; extremely high blood pressure accompanied by papilledema, organ damage, and so on Benign: More common; typically controlled with diet and medication Unspecified: Not stated in documentation whether the condition is malignant or benign 4 - 7

Essential Hypertension ·This is the most common type of hypertension. ·Use code 401 with the appropriate fourth digit. ·ALL hypertension codes require at least four digits

Hypertension + Heart ·Code 402.x: ·Heart condition DUE TO hypertension ·HYPERTENSIVE heart condition ·One code only 4 - 9

Hypertension + Heart ·Code 401.x + heart code: ·Heart condition WITH hypertension ·Code heart code xx: ·Heart failure DUE TO hypertension

Hypertension + Kidney ·Code 403.xx + second code: ·Fifth digit identifies the stage of chronic kidney disease. ·Second code reports specific stage of kidney disease

Hypertension + Heart + Kidney Code 404.xx: ·+ Code for heart failure ·+ Code for stage of kidney disease

Secondary Hypertension + Code 405.xx: ·First, list the underlying condition, that is, the disease that caused the patient to have hypertension. ·Second, list code 405.xx

Hypertension + Pregnancy Gestational hypertension 642.3x: ·Diagnosis of hypertension existed prior to the beginning of the pregnancy; code 401.x if no impact on mother’s condition

Hypertensive Retinopathy Two codes will be required: · Hypertensive retinopathy ·+ Hypertension code

Hypertensive Cerebrovascular Disease Two codes are required: ·430–438 Cerebrovascular disease ·+ Hypertension code

Cerebrovascular Issues ·Cerebrovascular accident (CVA) ·Stroke ·Cerebral infarction

Chapter Summary ·Circulatory conditions such as hypertension can be very complex due to their effect on the entire body. ·Ensure that the documentation is complete

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