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ICD-10 Ch 9 Circ-P1
Dx of Circulatory System- HTN, CKD
| Term | Definition |
|---|---|
| Hypertension | High Blood Pressure |
| What is one of the most common conditions reported with codes from Chapter 9? | Hypertension |
| Malignant hypertension | AKA accelerated hypertension; a severe form of hypertension |
| What are some symptoms of malignant hypertension? | headaches, blurred vision, dyspnea, uremia; BP > 200/140mm Hg |
| What is the prognosis for a patient with malignant hypertension? | poor |
| What is usually the outcome of malignant hypertension? | permanent organ failure |
| Benign hypertension | continuous mild hypertension that can usually be controlled with medication. |
| Is a coder allowed to determine whether a patient has hypertension based entirely on the blood pressure reading recorded in the medical record? | No. The provider must document a diagnosis of hypertension |
| How long would a patient with benign hypertension be expected to live? | a long life. |
| What are the dangers to benign hypertension? | If untreated, it becomes an important risk factor in coronary heart and cerebrovascular disease. |
| What is the expected course of malignant hypertension? | abrupt onset, runs its course in months; causes irreversible organ damage; often ends in renal failure or cerebral hemorrhage. |
| What causes essential hypertension? | the cause is unknown. |
| Hypertensive heart disease | Refers to secondary effects on the heart of prolonged, sustained, systemic hypertension. |
| What causes hypertensive heart disease? | The heart has to work against increased resistance. The primary effect is increased thickening of the left ventricle, which may eventually lead to heart failure. |
| Differentiate between controlled hypertension and uncontrolled hypertension. | Controlled hypertension is benign and controlled by medications or other treatment. Uncontrolled HTN is malignant, untreated, or not responding to medications or other treatments. |
| What code is used for controlled HTN? for uncontrolled HTN? | I10 is used for both. |
| If HTN is secondary to another condition, how is HTN coded? | The underlying condition is coded first. Then the HTN is coded from I15 category. |
| What would be underlying conditions that would lead to secondary HTN? | renal disorder, endocrine disorder, other secondary HTN, or unspecified. |
| How is sequencing of code determined for secondary HTN? | Sequencing depends on the reason for the visit/encounter |
| If HTN is transient, what code should be used? | R02.0 Elevated BP reading without diagnosis of HTN. |
| If a patient was previously diagnosed with HTN, when would the coder use code R02.0 Elevated BP reading without diagnosis of HTN? | Never |
| Proteinuria | large amount of protein in the urine that results from renal disease or other abnormal condition |
| If the patient is pregnant, how is HTN coded? | Use codes from Chapter 15, Ob - pregnancy codes for HTN, O13.- or O14.- |
| If a patient has both Hypertensive heart disease and CKD (which include HTN), what diagnosis codes should be used? | Use combination codes from I13. |
| If heart failure is present in patient has both Hypertensive heart disease and CKD, what diagnosis codes should be used? | I13 for HTN heart dx and CKD; Add I50 to identify the Heart failure. |
| If CKD is identified by any dx code, what code should be added? | N18 as a secondary code to identify the stage of CKD. |
| The codes in category I13 are what kind of codes and include what condition(s)? | combination codes including HTN, heart disease, CKD. |
| If an appropriate I13 code is present, is it okay for the coder to use separate diagnosis codes? | No. If and I13 code exists, I11 and I12 should not be used because I13 combines these conditions . |
| If a patient has both acute and chronic renal failure, what diagnosis is coded? | Both chronic and acute using two separate codes. |
| How many diagnosis codes are needed to correctly code CKD, HTN and chronic dialysis? | Three. CKD stage code, HTN code, chronic dialysis Z code |
| How many diagnosis codes are needed to correctly code ESRD, HTN and chronic dialysis? | Three. CKD stage code, HTN code, chronic dialysis Z code. |
| How many diagnosis codes are needed to correctly code CKD NOS, HTN and chronic dialysis? | Three. CKD stage code, HTN code, chronic dialysis Z code. |