Get the Scoop on Pulmonary Hypertension Coding

By Susan Dooley

Pulmonary hypertension, also called pulmonary arterial hypertension, or PAH, differs from the
hypertension were used to talking about.

Learn the Difference: Systemic Versus Pulmonary

Hypertension
Hypertension is high blood pressure all over the body, often also called arterial, primary, or systemic
hypertension, all of which are synonyms in the ICD-10-CM diagnosis code I10 (Essential [primary]
hypertension). When clinicians measure the blood pressure in your arm with a sphygmomanometer,
theyre screening for systemic hypertension. By the way, while ICD-9-CM called for differentiation
between benign or malignant hypertension, ICD-10-CM does not use those concepts.
Pulmonary hypertension, however, is high blood pressure in the arteries supplying the lungs. According
to the American Heart Association, pulmonary hypertension refers to high blood pressure in the arteries
of the lungs, occurring when the vessels of the pulmonary arterial system constrict and their walls
thicken. As a result, blood pressure builds. The right side of the heart pumps deoxygenated blood into
the lungs, and when the lungs arteries thicken and are unable to accommodate the blood volumes
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being pumped to the lungs for oxygenation, the right ventricle works harder and harder. Arrhythmias
can develop and the right ventricle can fail.

Reporting Pulmonary Hypertension

For primary pulmonary hypertension, youll report I27.0 (Primary pulmonary hypertension). Primary
pulmonary hypertension, also called idiopathic pulmonary arterial hypertension (IPAH), is relatively rare,
characterized by elevated pulmonary artery pressure without an apparent cause. To be able to report
this condition, your physician, physicians assistant, or nurse practitioner must document primary or
idiopathic pulmonary hypertension. Note that I27.0 carries an Excludes1 note listing pulmonary
hypertension NOS and secondary pulmonary hypertension.
To report secondary and NOS diagnoses, use the secondary code I27.2 (Other secondary pulmonary
hypertension). Secondary pulmonary hypertension can be caused by conditions such as pulmonary
emboli, emphysema, and connective tissue diseases.

Will ICD-10-CM 2017 Expand Pulmonary Hypertension

Code Offerings?
Bayer HealthCare Pharmaceuticals recently requested a group of new codes for pulmonary hypertension
that it said coincides with the way clinicians actually classify the disease. The World Health Organization
created this system of five diagnostic groups in 2009. WHO Group I covers pulmonary arterial
hypertension, Group II encompasses pulmonary hypertension caused by left heart disease, and Group III
includes pulmonary hypertension caused by lung disease and/or hypoxia. Group IV covers chronic
thromboembolic pulmonary hypertension, and Group V, pulmonary hypertension with unclear
multifactorial mechanisms. The ICD-10 Coordination and Maintenance Committee promised to seek
input from relevant medical societies before adding more codes to the ICD-10 code set.

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The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303
8150, shyamn@codinginstitute.com