Keep these strategies on assumptions, renal disease, and heart disease within reach.
Hypertension (HTN) is rising -- possibly a third of the U.S. population is at present affected. That implies that if your HTN coding skills aren’t top notch, a lot of your claims are at danger of errors.
For a compliant coding, apply these rules based on the ICD-9 official guidelines and know what ICD-9 codes you should choose.
1: ICD-9 Has a Hypertension Table; Use It
Coding HTN diagnoses can be challenging, however the Hypertension Table, listed in the ICD-9 index entry "Hypertension," helps streamline your search.
The table demonstrates not just the basic 401.x (Essential hypertension) ICD-9 codes, but also the ICD-9 codes for situations owing to or linked with HTN. Furthermore, the table helps explain when your code choices differ for malignant, benign, or unspecified conditions. After you’ve found the code in the index, don’t forget to check it in the tabular list.
2: Documentation Determines 401.x 4th Digit
ICD-9 official guidelines propose an important rule for compliant HTN coding. While reporting ICD-9 codes from 401.x, you should select a fourth digit to complete the code: "malignant (.0), benign (.1), or unspecified (.9). You should not use either .0 malignant or .1 benign without medical record documentation supporting such a designation.
3: ‘Hypertensive’ Supports 402.x Use
When a patient is going through HTN and heart disease, knowing whether the HTN resulted in the heart condition is vital to proper coding.
Look to find whether the patient has a situation defined under heart disease ICD-9 codes 425.8, 429.0-429.3, 429.8, and 429.9, official guidelines maintain. Moreover scrutinize the documentation for a stated or implied underlying relationship to HTN (for example, "due to HTN" or "hypertensive heart disease"). You should never suppose that the HTN resulted in the heart disease.
4: Assume HTN and CKD Are Connected
In direct contrast to the rules for coding HTN as well as heart disease, ICD-9 does assume a fundamental relationship between HTN and chronic kidney disease (CKD).
Translation: In case documentation demonstrates that a patient has HTN and a condition that falls under 585.x (Chronic renal failure) or 587 (Renal sclerosis unspecified), then you must report a code from 403.x (Hypertensive renal disease), even though there’s no sign that one lead to the other. You also should report the pertinent 585.x code to specify the CKD stage.
5: Unclutter Coding for Hypertensive Heart and CKD
A particular code from 404.xx (Hypertensive heart and renal disease) specifies that the patient has hypertensive heart disease along with hypertensive CKD. You again should presume a relationship between the HTN and CKD.
Crucial: When the patient is going through hypertensive heart disease and CKD, you must select a code from 404.xx. You must not report 402.x (hypertensive heart disease) along with 403.x (hypertensive CKD).
Hypertension (HTN) is rising -- possibly a third of the U.S. population is at present affected. That implies that if your HTN coding skills aren’t top notch, a lot of your claims are at danger of errors.
For a compliant coding, apply these rules based on the ICD-9 official guidelines and know what ICD-9 codes you should choose.
1: ICD-9 Has a Hypertension Table; Use It
Coding HTN diagnoses can be challenging, however the Hypertension Table, listed in the ICD-9 index entry "Hypertension," helps streamline your search.
The table demonstrates not just the basic 401.x (Essential hypertension) ICD-9 codes, but also the ICD-9 codes for situations owing to or linked with HTN. Furthermore, the table helps explain when your code choices differ for malignant, benign, or unspecified conditions. After you’ve found the code in the index, don’t forget to check it in the tabular list.
2: Documentation Determines 401.x 4th Digit
ICD-9 official guidelines propose an important rule for compliant HTN coding. While reporting ICD-9 codes from 401.x, you should select a fourth digit to complete the code: "malignant (.0), benign (.1), or unspecified (.9). You should not use either .0 malignant or .1 benign without medical record documentation supporting such a designation.
3: ‘Hypertensive’ Supports 402.x Use
When a patient is going through HTN and heart disease, knowing whether the HTN resulted in the heart condition is vital to proper coding.
Look to find whether the patient has a situation defined under heart disease ICD-9 codes 425.8, 429.0-429.3, 429.8, and 429.9, official guidelines maintain. Moreover scrutinize the documentation for a stated or implied underlying relationship to HTN (for example, "due to HTN" or "hypertensive heart disease"). You should never suppose that the HTN resulted in the heart disease.
4: Assume HTN and CKD Are Connected
In direct contrast to the rules for coding HTN as well as heart disease, ICD-9 does assume a fundamental relationship between HTN and chronic kidney disease (CKD).
Translation: In case documentation demonstrates that a patient has HTN and a condition that falls under 585.x (Chronic renal failure) or 587 (Renal sclerosis unspecified), then you must report a code from 403.x (Hypertensive renal disease), even though there’s no sign that one lead to the other. You also should report the pertinent 585.x code to specify the CKD stage.
5: Unclutter Coding for Hypertensive Heart and CKD
A particular code from 404.xx (Hypertensive heart and renal disease) specifies that the patient has hypertensive heart disease along with hypertensive CKD. You again should presume a relationship between the HTN and CKD.
Crucial: When the patient is going through hypertensive heart disease and CKD, you must select a code from 404.xx. You must not report 402.x (hypertensive heart disease) along with 403.x (hypertensive CKD).
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