Pulmonary Hypertension ICD-10-CM Coding
Earlier this year, the pulmonary hypertension community of medical professionals and advocates banded together with ATS to create a marked difference for the world of PH.
New and revised ICD-10-CM codes will become effective for claims submitted with dates of service on or after October 1, 2017. phaware® is pleased to share this important information as it positively affects our entire community.
Dr. Manaker discusses the new and revised ICD-10-CM codes, which creates a marked difference for the world of PH.
Why is Proper Coding Important?
Nelly Leon-Chisen, RHIA, director of coding and classification at the American Hospital Association says, “Medical coding is there to help present a picture…” And with the breadth of use of the coding system today, improved data will support a host of health care needs including:
Measuring the quality, safety, and efficacy of care
Designing payment systems and processing claims for reimbursement
Conducting research, epidemiological studies, and clinical trials
Setting health policy
Operational and strategic planning and designing healthcare delivery systems
Monitoring resource utilization
Improving clinical, financial, and administrative performance
Preventing and detecting healthcare fraud and abuse
Tracking public health and risks
ICD-10-CM has these intrinsic benefits:
Greater level of specificity and clinical detail, and improvements in the capture of advances in medical technology
Medical terminology and classification of diseases have been updated to be consistent with current clinical practice
Comparability between mortality and morbidity data
Article citation: Fuller, Sandra R.. "Importance of ICD-10" ICD-TEN (May 2009).
New ICD-10-CM Coding Changes
New and revised ICD-10-CM coding effective for claims submitted with dates of service on or after October 1, 2017
I27.0 Primary pulmonary hypertension
Primary Group 1 pulmonary arterial hypertension Primary pulmonary hypertension
Excludes secondary pulmonary hypertension
I27.2 Other secondary pulmonary hypertension
I27.20 Pulmonary hypertension, unspecified
Pulmonary hypertension NOS
I27.21 Secondary pulmonary arterial hypertension
Drug, toxin-induced pulmonary arterial hypertension NOS
Drug, toxin-induced secondary Group 1 pulmonary hypertension
Code also: associated conditions if applicable, or adverse e ects of drugs or toxinsAdverse effect of appetite depressants (T50.5X5) Congenital heart disease (Q20-Q28)
HIV (B20)
Portal hypertension (K76.6)Collagen vascular disease (M33.2-, M34.-, M05.-)
Schistosomiasis (B65.-)
I27.22 Pulmonary hypertension due to left heart disease
Group 2 pulmonary hypertension
Code also associated left heart disease, if known, such as:Multiple valve disease (I08.-) Rheumatic mitral valve diseases (I05.-) Rheumatic aortic valve diseases (I06.-)
I27.23 Pulmonary hypertension due to lung diseases and hypoxia
Group 3 pulmonary hypertension
Code also associated lung disease, if known, such as:Bronchiectasis (J47.-)
Cystic fibrosis with pulmonary manifestations (E84.0) Interstitial lung disease (J84.-)
Pleural effusion (J90)
Sleep apnea (G47.3-)I27.24 Chronic thromboembolic pulmonary hypertension
Group 4 pulmonary hypertension
Code also associated pulmonary embolism, if applicable (I26.-, I27.82)
I27.29 Other secondary pulmonary hypertension
Group 5 pulmonary hypertension
Pulmonary hypertension with unclear multifactorial mechanisms Pulmonary hypertension due to hematologic disorders Pulmonary hypertension due to metabolic disorders
Pulmonary hypertension due to other systemic disorders
Code also other associated disorders, if known, such as: Chronic myeloid leukemia (C92.10-C92.22) Essential thrombocythemia (D47.3)
Gaucher disease (E75.22)
Hypertensive chronic kidney disease with end stage renal disease (I12.0, I12.11, I13.2) Hyperthyroidism (E05.-)
Hypothyroidism (E00-E03)
Polycythemia vera (D45)
Sarcoidosis (D86.-)
I27.8 Other specified pulmonary heart diseases
I27.83 Eisenmenger’s syndrome
Eisenmenger’s complex
(Irreversible) Eisenmenger’s disease
Pulmonary hypertension with right to left shunt related to congenital heart disease Code also underlying heart defect, if known, such as:
Atrial septal defect (Q21.1) Eisenmenger’s defect (Q21.8) Patent ductus arteriosus (Q25.0) Ventricular septal defect (Q21.0)
I27.89 Other speci ed pulmonary heart diseases
Eisenmenger’s complex
Eisenmenger’s syndrome
Excludes Eisenmenger’s defect (Q21.8)