This document discusses hypertension (high blood pressure), including definitions, types, causes, complications, treatment options, and ICD-10 coding guidelines. It defines normal blood pressure and the two main types of hypertension: primary (essential) and secondary, which has an identifiable cause such as kidney disease or obesity. Treatment options include lifestyle modifications and several classes of pharmacological treatments that act on blood pressure in different ways. The document concludes by explaining the new ICD-10 codes for hypertensive urgency and emergency, and providing definitions to guide accurate use of these codes.

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2.  DEFINITION: Elevated blood pressure above
the normal to a period of time is known as
hypertension
 NORMAL BLOOD PRESSURE:According to
recent studies 140/90 based on people life
style, environment.

3.  Mainly classified into two types
I. PRIMARY HYPERTENSION:It is also known
as essential hypertension.
CAUSES:unknown.
2. SECONDARY HYPERTENSION:identifiable
cause like:kidney
diseases,hyperthyroidism,hypothyroidism
obesity etc.

5. 1.Kideney disease
2.Hyper thyroidism
3.Hypo thyroidism
4.Alcohol consumption
5.Smoking
6.Obesity
7.High consumption of salt in food.

6.  ISCHEMIC HEART DISEASES
 STROKES
 PERIPHERAL VASCULAR DISEASE
 HEART FAILURE
 AORTIC ANEURYSMS
 ATEROSCLEROSIS
 PULMONARY EMBOLISM
 CKD

7.  PHARMACOLOGICAL TREATMENT:Examples
 CALCIUM CHANNEL BLOCKERS:
verapamil,diltiazem,cilnidipine,felodipine.
MOA:acts by inhibitng the calcium channels
 Beta-blockers:
metaprolol,propranolol,atenolol.
MOA:acts by blocking the b receptors.
 ACE INHIBITORS:examples:
captopril,enalapril.
MOA:acts by blocking angiotensin converting enzyme.

8.  THIAZIDE DIURETICS:examples
 Chlorthalidone,hydrochlorthiazide.
 MOA:acts by inhibiting the re absorption of
sodium and calcium.
 ANGIOTENSIN RECEPTOR BLOCKERS:
 Telmisartan, irbesartan.
 MOA:acts by blocking angiotensin receptors.

9.  LIFE STYLE MODIFICATION
 DIET MODIFICATION
 AVOIDING ALCOHOL CONSUMPTION
 AVOIDING SMOKING
 EXERCISE

10.  Hypertension: ICD-10-CM for 2017 provides
specific codes for hypertensive urgency and
emergency, which are both considered
hypertension crises. In the switch to ICD-10-
CM, hypertension stopped being classified as
malignant, benign, or unspecified, as it was in
ICD-9-CM, and the terms “emergency” and
“urgency” disappeared. The update for 2017
adds these two terms back in and goes one step
further by having specific codes for the
concepts.

11.  I16.0 Hypertensive urgency
 I16.1 Hypertensive emergency
 I16.9 Hypertensive crisis, unspecified
Both I16.1 (Hypertensive emergency) and I16.9
(Hypertensive crisis, unspecified) classify to a
complication or comorbidity (CC) and,
interestingly, do not have any excludes notes
for use with other codes.

12.  Correct coding now depends on knowing what
constitutes an urgent versus an emergent case of
hypertension:
 Hypertensive urgency is characterized by systolic
blood pressure (SBP) greater than 180 mm Hg or
diastolic blood pressure (DBP) greater than 110 mm Hg
with symptoms such as headache, dyspnea, or chest
pain but without end-organ involvement.
Hypertensive emergency is distinguished by SBP
greater than 180 mm Hg or DBP greater than 120 mm
Hg with end-organ involvement such as neurologic,
renal, or cardiac systems

13.  Emergency: Blood pressure reaches levels indicating impending
or progressive organ damage. Such levels usually exceed 180
systolic and 120 dystolic, but could be lower in patients without
previous high blood pressure. The patient is at risk for stroke, loss
of consciousness, memory loss, acute myocardial infarction or
angina, aortic dissection, damage to the eyes and kidneys, and
pulmonary edema. For pregnant patients, a hypertensive
emergency could lead to eclampsia.
 “urgent” (no severity impact)
 “crisis” (having severity impact)
 An additional code should be used to code an identified
hypertensive disease with the sequencing then based on the
circumstances of the admission.

14.  If the provider’s documentation doesn’t specify
urgency or emergency, you’ll report the
unspecified code.
 Dr. Santosh Kumar GupthaTrainer/Author
 CCS-P, CCS , CPC, COC, CIC, CPC-P, CRC, CCC,
CPCO, CANPC, CPB, CPMA, CEMC, CEDC,
CIMC, CFPC, CUC, COBGC, CPCD, COSC, CPRC,
CPEDC, CHONC, CENTC, CRHC, CGIC, CASCC,
CGSC, CSFAC, CCVTC, RMC, RMA, CMBS,
CMRS, CSCS, CSBB, FCR, FNR, FOR, CHA, CHL7,
AHIMA Approved ICD-10 Trainer, AHIMA ICD-
10 Ambassador http://www.medesunglobal.com

15.  For more details of Medical Coding Training
Visit Medesun Global Website.