Health Information Management

Q&A: Coding for labile hypertension

JustCoding News: Outpatient, June 13, 2012

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QUESTION: I've always coded labile hypertension with ICD-9-CM code 401.9 (unspecified essential hypertension) because I couldn't find a more specific one. My supervisor stated that I must use ICD-9-CM code 796.2 (elevated blood pressure reading without diagnosis of hypertension) because it means the patient's blood pressure was high without a history of hypertension. The physician's diagnosis is labile hypertension. What code would you use?

ANSWER: The definition of ‘labile hypertension’ is dramatically changing levels of high blood pressure. The point I see here is that the physician diagnosed the patient with “labile hypertension.”
 
Hypertension, labile or not, is a very specific diagnosis. ICD-9-CM alphabetic index includes ‘labile’ as a non-essential modifier of hypertension reported with 401.9 (for unspecified as benign or malignant). This confirms that, based on the information you provided, the correct code would be 401.9.
 
 
Editor’s note: Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CHA, of Safian Communications Services in Orlando, Fla., answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee, Wis. Email her at ssafian@embarqmail.com.
 
This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
 
Need expert coding advice? Submit your question to Senior Managing Editor Michelle Leppert, CPC-A, at mleppert@hcpro.com, and we’ll do our best to get an answer for you.



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