ICD-10 Coding for Resistant Hypertension(I1A.0)
Complete ICD-10-CM coding and documentation guide for Resistant Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Resistant Hypertension
I10-I16Primary Range
Hypertensive diseases
This range includes codes for various types of hypertension, including resistant hypertension.
Key Information: ICD-10 code for resistant hypertension
Essential facts and insights about Resistant Hypertension
Primary ICD-10-CM Code for resistant hypertension
Decision Criteria
clinical Criteria
- BP remains uncontrolled on three medications including a diuretic
documentation Criteria
- Documentation must specify medication names, doses, and BP readings
Applicable To
- Apparent treatment resistant hypertension
- True resistant hypertension
Excludes
- Secondary hypertension (I15.-)
Clinical Validation Requirements
- BP remains ≥130/80 mmHg on three antihypertensive medications, including a diuretic
- Exclusion of pseudoresistance through ambulatory BP monitoring
- Medication adherence confirmed
Code-Specific Risks
- Incorrect sequencing with underlying hypertension codes
- Lack of documentation on medication adherence
Coding Notes
- Ensure documentation specifies the use of three antihypertensive medications including a diuretic and confirms uncontrolled BP.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Resistant Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I1A.0.
Impact
Clinical: May lead to misdiagnosis of resistant hypertension., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Include adherence checks in documentation, Use electronic pill counts or urine tests
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always code the underlying hypertension first, followed by I1A.0.
Impact
Lack of adherence documentation may lead to audit findings.
Mitigation Strategy
Implement routine adherence checks and document findings.
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 Resistant Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Resistant Hypertension
Use these documentation templates to ensure complete and accurate documentation for Resistant Hypertension. These templates include all required elements for proper coding and billing.
Patient with uncontrolled BP on three medications
Specialty: CardiologyRequired Elements
- Medication names and doses
- BP readings
- Confirmation of medication adherence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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