ICD-10 Coding for Pulmonary Artery Hypertension(I27.0, I27.21, I27.22, I27.23, I27.24)
Complete ICD-10-CM coding and documentation guide for Pulmonary Artery Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pulmonary Artery Hypertension
I27.0-I27.2Primary Range
Pulmonary Heart Disease
This range includes primary and secondary pulmonary hypertension codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I27.0 | Primary pulmonary hypertension | Use when PAH is idiopathic or heritable, confirmed by RHC. |
|
| I27.21 | Secondary pulmonary arterial hypertension due to drugs | Use when PAH is due to drug or toxin exposure. |
|
| I27.22 | Pulmonary hypertension due to left heart disease | Use when PH is due to left heart disease. |
|
| I27.23 | Pulmonary hypertension due to lung diseases | Use when PH is due to lung disease. |
|
| I27.24 | Chronic thromboembolic pulmonary hypertension | Use when PH is due to chronic thromboembolic 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 pulmonary artery hypertension
Essential facts and insights about Pulmonary Artery Hypertension
Primary ICD-10-CM Codes for pulmonary artery hypertension
Decision Criteria
clinical Criteria
- Idiopathic or heritable PAH confirmed by RHC.
Applicable To
- Idiopathic PAH
- Heritable PAH
Excludes
- Secondary pulmonary hypertension (I27.2)
Clinical Validation Requirements
- RHC showing mPAP >20 mmHg, PCWP ≤15 mmHg, PVR ≥3 WU
Code-Specific Risks
- Risk of incorrect coding without RHC confirmation.
Coding Notes
- Ensure RHC results are documented.
I27.21 - Secondary pulmonary arterial hypertension due to drugs
Use when PAH is due to drug or toxin exposure.
Applicable To
- Drug-induced PAH
Clinical Validation Requirements
- Documentation of causative drug and RHC findings.
Coding Notes
Link to drug code (e.g., T45.1X5).
I27.22 - Pulmonary hypertension due to left heart disease
Use when PH is due to left heart disease.
Applicable To
- PH due to heart failure
Clinical Validation Requirements
- RHC showing PCWP >15 mmHg.
Coding Notes
Link to heart disease code (e.g., I50.9).
I27.23 - Pulmonary hypertension due to lung diseases
Use when PH is due to lung disease.
Applicable To
- PH due to COPD
- PH due to interstitial lung disease
Clinical Validation Requirements
- RHC findings and lung disease documentation.
Coding Notes
Link to lung disease code (e.g., J44.9).
I27.24 - Chronic thromboembolic pulmonary hypertension
Use when PH is due to chronic thromboembolic disease.
Applicable To
- CTEPH
Clinical Validation Requirements
- V/Q scan and angiographic evidence of thrombi.
Coding Notes
Link to chronic PE code (e.g., I26.99).
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other secondary pulmonary hypertension
I27.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pulmonary Artery Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I27.0.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure RHC results are documented in the patient's record.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Confirm idiopathic or heritable nature via RHC.
Impact
Using non-specific codes without RHC confirmation.
Mitigation Strategy
Require RHC results for all PAH diagnoses.
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 Pulmonary Artery Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pulmonary Artery Hypertension
Use these documentation templates to ensure complete and accurate documentation for Pulmonary Artery Hypertension. These templates include all required elements for proper coding and billing.
Initial PAH Workup
Specialty: CardiologyRequired Elements
- Chief complaint
- History of present illness
- Past medical history
- RHC results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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