ICD-10 Coding for Pulmonary Hypertension(I27.0, I27.21)
Complete ICD-10-CM coding and documentation guide for Pulmonary Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pulmonary Hypertension
I27.0-I27.29Primary 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 no identifiable cause for pulmonary hypertension is present. |
|
| I27.21 | Secondary pulmonary arterial hypertension | Use when pulmonary hypertension is secondary to left heart 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 primary pulmonary hypertension
Essential facts and insights about Pulmonary Hypertension
Primary ICD-10-CM Codes for pulmonary hypertension
Decision Criteria
clinical Criteria
- Confirmed idiopathic or heritable PAH with no secondary cause.
Applicable To
- Idiopathic pulmonary arterial hypertension
- Heritable pulmonary arterial hypertension
Excludes
- Secondary pulmonary hypertension (I27.2-)
Clinical Validation Requirements
- Right heart catheterization showing mean pulmonary arterial pressure (mPAP) >20 mmHg
Code-Specific Risks
- Incorrectly using for secondary causes
Coding Notes
- Ensure documentation specifies 'primary' or 'idiopathic'.
I27.21 - Secondary pulmonary arterial hypertension
Use when pulmonary hypertension is secondary to left heart disease.
Applicable To
- Pulmonary hypertension due to left heart disease
Excludes
- Primary pulmonary hypertension (I27.0)
Clinical Validation Requirements
- Echocardiogram or right heart catheterization confirming secondary cause
Coding Notes
Link PH to the underlying heart disease explicitly.
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 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: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific language linking PH to its cause, Provide test results confirming diagnosis
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies the cause and use appropriate secondary codes.
Impact
Failure to code the underlying cause of PH.
Mitigation Strategy
Implement thorough documentation reviews.
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 Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pulmonary Hypertension
Use these documentation templates to ensure complete and accurate documentation for Pulmonary Hypertension. These templates include all required elements for proper coding and billing.
Secondary PH due to COPD
Specialty: PulmonologyRequired Elements
- Underlying cause
- Diagnostic tests
- Linkage phrases
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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