ICD-10 Coding for Severe Pulmonary Hypertension(I27.0, I27.21)
Complete ICD-10-CM coding and documentation guide for Severe Pulmonary Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Severe Pulmonary Hypertension
I27.0-I27.9Primary Range
Pulmonary heart disease and diseases of pulmonary circulation
This range includes codes for primary and secondary pulmonary hypertension, crucial for accurate diagnosis and treatment documentation.
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 primary pulmonary hypertension is confirmed by clinical validation and no secondary causes are identified. |
|
| I27.21 | Secondary pulmonary arterial hypertension | Use when pulmonary arterial hypertension is secondary to another condition like connective tissue 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 severe pulmonary hypertension
Essential facts and insights about Severe Pulmonary Hypertension
Primary ICD-10-CM Codes for severe pulmonary hypertension
Decision Criteria
clinical Criteria
- mPAP ≥25 mmHg and PCWP ≤15 mmHg confirmed by RHC
Applicable To
- Idiopathic pulmonary arterial hypertension
Excludes
- Secondary pulmonary hypertension (I27.2-)
Clinical Validation Requirements
- Mean pulmonary artery pressure (mPAP) ≥25 mmHg at rest via right heart catheterization
- Pulmonary capillary wedge pressure ≤15 mmHg
- Exclusion of secondary causes
Code-Specific Risks
- Incorrectly coding secondary causes as primary
Coding Notes
- Ensure right heart catheterization results are documented to support the use of this code.
I27.21 - Secondary pulmonary arterial hypertension
Use when pulmonary arterial hypertension is secondary to another condition like connective tissue disease.
Applicable To
- Pulmonary hypertension due to connective tissue disease
Excludes
- Primary pulmonary hypertension (I27.0)
Clinical Validation Requirements
- Documentation of secondary cause such as connective tissue disease or congenital heart disease
Coding Notes
Ensure the underlying condition is documented and coded first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Severe Pulmonary 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: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Ensure detailed documentation of hemodynamic measurements, Specify primary vs. secondary causes
Impact
Reimbursement: Incorrect coding can lead to denied claims or reduced reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data affecting patient care and research.
Mitigation Strategy
Ensure secondary causes are identified and coded appropriately.
Impact
Audits often find errors in distinguishing between primary and secondary pulmonary hypertension.
Mitigation Strategy
Implement thorough documentation practices and regular coder training.
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 Severe Pulmonary Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Severe Pulmonary Hypertension
Use these documentation templates to ensure complete and accurate documentation for Severe Pulmonary Hypertension. These templates include all required elements for proper coding and billing.
Cardiology evaluation for severe pulmonary hypertension
Specialty: CardiologyRequired Elements
- Pulmonary artery pressure measurements
- Right heart catheterization results
- WHO functional class
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Severe Pulmonary Hypertension? Ask your questions below.