Elevated blood pressure without hypertension icd 10

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First, you need to provide keywords in the Search Text field then check the properties that you'd like to include in the search.

The system will search for the keywords in the properties that you've checked and rank the results similar to a search engine

The results will be displayed in the Search Results pane. If the search query hits more than 200 results, then only the top 200 will be displayed.

If you provide more than one keyword, the system will search for items that have all the keywords.

Wildcards: You may also use wildcard character * . see examples below.

OR operator : It's possible to have the results that have either one or another keyword. Please see the example 4.

Examples:

1. Search Text: diabetes   {finds all that have the word "diabetes" in the searched fields}

2. Search Text: diabet*   {finds all that have a word that start with "diabet" }

3. Search Text: diabet* mellitus   {finds all that have a word that starts with "diabet" and also contains the word "mellitus"}

4. Search Text: tubercul* (lung OR larynx) { finds all that have a word that starts with "tubercul" and than has either lung OR larynx in it

Search Results

After the search the results are displayed at the lower right area of the screen. Here the porgram lists the titles of the ICD categories in which your search keywords are found.

Advanced search lets you search selected properties of the classification. You could search all properties or a selected subset only

First, you need to provide keywords in the Search Text field then check the properties that you'd like to include in the search.

The system will search for the keywords in the properties that you've checked and rank the results similar to a search engine

The results will be displayed in the Search Results pane. If the search query hits more than 200 results, then only the top 200 will be displayed.

If you provide more than one keyword, the system will search for items that have all the keywords.

Wildcards: You may also use wildcard character * . see examples below.

OR operator : It's possible to have the results that have either one or another keyword. Please see the example 4.

Examples:

1. Search Text: diabetes   {finds all that have the word "diabetes" in the searched fields}

2. Search Text: diabet*   {finds all that have a word that start with "diabet" }

3. Search Text: diabet* mellitus   {finds all that have a word that starts with "diabet" and also contains the word "mellitus"}

4. Search Text: tubercul* (lung OR larynx) { finds all that have a word that starts with "tubercul" and than has either lung OR larynx in it

Search Results

After the search the results are displayed at the lower right area of the screen. Here the porgram lists the titles of the ICD categories in which your search keywords are found.

The International Classification of Diseases (ICD) is an ever‐present factor and often irritant in the lives of clinicians. Although physicians view ICD codes as necessary for reimbursement claims, in fact they are also used for developing mortality data, influencing the development of health care policy, pointing directions for basic and applied research, and assisting in the decisions regarding allocation of resources for research and development. The ICD further serves as a classification system for causes of death and includes rules for coding causes of death, standardization of definitions such as “underlying cause of death,” tabulation lists that recommend the cause‐of‐death groupings used to present mortality data that can be compared among countries, formatting of the medical certification of death that is part of every death certificate in the United States, and the compilation and publication of statistics on diseases and causes of death.

It is our impression that the average physician spends considerable time battling with the choice of appropriate codes that poorly correspond to current disease concepts. Physicians in general, however, have no idea how these codes were developed and spend very little time pondering the process by which the ICD has been developed.

The primary sponsor of the ICD is the World Health Organization in collaboration with approximately 10 centers, primarily from Europe. 1 The ICD was introduced in the late 19th century. The 9th revision of the ICD (ICD‐9), used in the United States from 1979 until 1998 (the 10th revision (ICD‐10) is currently being implemented), has proven woefully inadequate for appropriately identifying high blood pressure and hypertensive heart disease. A personal favorite is 401.1, “benign hypertension with heart failure.” Many of us have had considerable difficulty in considering hypertension as “benign,” and are not sure what “malignant” hypertension indicates as an isolated entity. Is this the presence of metastatic vascular hypertrophy? Table compares existing ICD‐9 codes with the ICD‐10 codes that are currently being implemented. Unfortunately, beginning with the title of the table, ie, “Essential Hypertension,” the coding still leaves much to be desired. Attempts have been made for years to expunge the archaic concept of “essential” when describing this greatest of cardiovascular health problems, and yet in remains in IDC‐10.

Table TABLE

 Essential Hypertension

ICD‐9‐CMICD‐10‐CM401.9: Essential hypertension, unspecified110: Essential (primary) hypertensionAlphabetic index entriesMalignant
401.0Benign
401.1Unspecified
401.9NoneTabular entries401: Essential hypertension110: Essential (primary) hypertension Includes Includes  High blood pressure  High blood pressure  Hyperpiesia  Hypertension (arterial) (benign) (essential) (malignant) (primary)  Hyperiesis hypertension (arterial)  Systemic Excludes Excludes involving vessels of  Elevated blood pressure without diagnosis of hypertension (796.2)  Brain (160–169)  Pulmonary hypertension (416.0–416.9)  Eye (H35.0)  That involving vessels of:
   Brain (430–438)
   Eye (362.11)Code differences Hypertension table No hypertension table Classification by type Hypertension no longer classified using those terms; hypertension does not use type as defining classification  Malignant  Benign  UnspecifiedElevated blood pressure reading without diagnosis of hypertension 769.2: Elevated blood pressure without diagnosis of hypertension R03.0: Elevated blood pressure reading, without diagnosis of hypertension 796.3: Nonspecific low blood pressure reading R03.1: Nonspecific low blood pressure reading

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Abbreviations: ICD‐9‐CM, International Classification of Diseases, Ninth Revision, Clinical Modification; ICD‐10‐CM, International Classification of Diseases, Tenth Revision, Clinical Modification.

On a very practical note for the hypertension specialist, the ICD code will influence reimbursement. Now that the National Uniforms Claims Commission has granted the hypertension specialist a taxonomy code, medical billing will include this code along with level of service and applicable current procedural codes. Resistant hypertension has been designated as 997.91 in the ICD‐9 codes. Unfortunately, there is no designation for “resistant hypertension” in the ICD‐10 despite the increasing recognition of resistant hypertension as a major clinical entity, which, by definition, should indicate a more complex level of service. At this time, resistant hypertension must be dealt with by adding complexity of illness codes, ie, by definition resistant hypertension is a highly complex illness.

At least there is now an understanding that hypertension is a disease and that blood pressure is a biomarker. Thus, the white‐coat effect can be coded with the designation R03.0, “elevated blood pressure without hypertension.” This gives hope that the definition of hypertension written by the American Society of Hypertension Writing Group that describes hypertension in stages defined not only by blood pressure, but importantly by the presence of associated cardiovascular risk factors and target organ damage, will eventually be adopted by future ICD codes.

Matching the ICD‐10 codes with the different current procedural terminology codes will require some negotiating. However, this is a welcome problem considering the difficulties hypertension specialists have had in claiming reimbursement in the past. As an example of this, the Centers for Medicare & Medicaid Services currently reimburses ambulatory blood pressure measurement (ABPM) only if performed in conjunction with ICD‐9 code 796.2 (ICD‐10 R03.0). It has been reported that when patients with diagnoses of resistant hypertension are evaluated with ABPM, as many as one third are actually found to be controlled, yet there is currently no ICD‐10 designation and no approved reimbursement for ABPM. We believe that when a hypertension specialist orders an ABPM, third‐party payers should reimburse for this service since the procedure is clearly cost‐effective in the evaluation of the white‐coat effect and resistant hypertension, as well as improving the care of patients. In fact, the current National Institute for Clinical Excellence guidelines published in the United Kingdom suggests ABPM for all patients being treated for hypertension.

Now is a good time for the American Society of Hypertension to convene a group to look to future ICDs. It takes about 10 years for changes to be made; now is not too early to begin. Appropriate coding is essential not only for patient care but for planning future research needs. This is much too important a task to leave for someone else to do.

Reference

1. New International Classification of Diseases (ICD‐10): the History and Impact. Brief Health Statistics Section

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