ICD-10 Coding for Moderate Pulmonary Hypertension(I27.20, I27.22)
Complete ICD-10-CM coding and documentation guide for Moderate Pulmonary Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Moderate Pulmonary Hypertension
I27.20-I27.29Primary Range
Other pulmonary heart diseases
This range includes codes for pulmonary hypertension with varying causes and severities, including moderate cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I27.20 | Pulmonary hypertension, unspecified | Use when moderate pulmonary hypertension is diagnosed without a specified underlying cause. |
|
| I27.22 | Pulmonary hypertension due to left heart disease | Use when PH is secondary to left heart disease. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for moderate pulmonary hypertension
Essential facts and insights about Moderate Pulmonary Hypertension
Primary ICD-10-CM Codes for moderate pulmonary hypertension
Decision Criteria
clinical Criteria
- Moderate PH confirmed by echocardiogram or RHC.
Applicable To
- Moderate pulmonary hypertension
Excludes
- Primary pulmonary hypertension (I27.0)
Clinical Validation Requirements
- Echocardiogram showing RVSP 40-59 mmHg
- Mean PAP ≥25 mmHg by RHC
Code-Specific Risks
- Risk of undercoding if underlying cause is not documented.
Coding Notes
- Ensure documentation specifies the absence of a known cause if using I27.20.
I27.22 - Pulmonary hypertension due to left heart disease
Use when PH is secondary to left heart disease.
Applicable To
- PH due to left ventricular dysfunction
Excludes
- PH due to lung diseases (I27.23)
Clinical Validation Requirements
- LVEF <40% with elevated PAWP >15 mmHg
Coding Notes
Ensure heart disease is documented and coded prior to PH.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Heart failure, unspecified
I50.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Moderate Pulmonary Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I27.20.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Potential audit issues., Financial: Incorrect reimbursement.
Mitigation Strategy
Always query for underlying conditions., Use templates to ensure completeness.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use I27.20 or a more specific code for secondary PH.
Impact
Failure to sequence underlying conditions before PH.
Mitigation Strategy
Educate staff on proper sequencing rules.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Moderate Pulmonary Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Moderate Pulmonary Hypertension
Use these documentation templates to ensure complete and accurate documentation for Moderate Pulmonary Hypertension. These templates include all required elements for proper coding and billing.
Pulmonology Progress Note
Specialty: PulmonologyRequired Elements
- RVSP measurement
- mPAP value
- Underlying conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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