Oct 01, 2021 · R03.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Elevated blood-pressure reading, w/o diagnosis of htn; The 2022 edition of ICD-10-CM R03.0 became effective on October 1, 2021.
This category is to be used to record an episode of elevated blood pressure in a patient in whom no formal diagnosis of hypertension has been made, or as an isolated incidental finding. ICD-10-CM Diagnosis Code Z01.31
2022 ICD-10-CM Codes R03*: Abnormal blood-pressure reading, without diagnosis. ICD-10-CM Codes. ›. R00-R99 Symptoms, signs and abnormal clinical and …
Mar 07, 2019 · The ICD-10 codes for diagnosing hypertension and other related conditions include – I10 – Primary (essential) hypertension I15 – Secondary hypertension I15.0 – Renovascular hypertension I15.1 – Hypertension secondary to other renal disorders I15.2 – Hypertension secondary to endocrine disorders I15.8 – Other secondary hypertension
Because ICD-10 can be a distressing topic, let's start with some good news: Hypertension has a limited number of ICD-10 codes – only nine codes for primary hypertension and five codes for secondary hypertension. This makes the task of coding hypertension relatively simple – well, at least compared to some of the other ICD-10 complexities.
The exception to this is I15.8, Other secondary hypertension. Because this is an “other” code, the “other” condition must be coded first.
When an individual has hypertension and heart disease, it is up to the provider to determine whether there is a causal relationship stated or implied. This relationship determination is spelled out in the “Official Guidelines for Coding and Reporting” (draft 2014). 1
The ICD-10 manual does not list the required documentation for hypertensive heart disease. It is recommended, however, that the provider document the basis for the diagnosis (exam, electrocardiogram, echocardiogram, etc.) at least the first time this diagnosis is made for the patient.
Unlike hypertension and heart disease, where the provider must determine whether a causal relationship exists, if the patient has hypertension and develops chronic kidney disease, ICD-10 presumes a cause and effect relationship and classifies the condition as hypertensive chronic kidney disease.
In most cases, you would use one of the following codes found in chapter 5 , “Mental, Behavioral, and Neurodevelopmental Disorders”:
As physicians, we are well aware that hypertension is never truly “benign,” and the removal of this antiquated term is a welcome improvement in the lexicon of diseases. But, of course, nothing is easy in ICD-10, and there are several things you need to be aware of before we dig into the codes themselves.
To record an episode of elevated blood pressure in a patient who has no formal diagnosis of hypertension or an isolated incidental finding, you should report ICD-10 code R03.0, “Elevated blood-pressure reading, without diagnosis of hypertension.” This code applies to borderline, transient, or white-coat hypertension.
To report hypertensive heart disease, use a code from category I11 (e.g., I11.0, “Hypertensive heart disease with heart failure”) and report a code for the type of heart failure (e.g., I50.32, “Chronic diastolic heart failure”). Reporting the presence of these conditions is appropriate per ICD-10 guidelines: “Code all documented conditions that coexist at the time of the encounter/visit and require or affect patient care treatment or management.” Failure to document them may also affect the bottom line in value-based payment environments.
HYPERTENSION IN RISK ADJUSTMENT. A diagnosis of hypertension (I10) does not affect a patient's risk-adjustment score. However, hypertension with heart or kidney disease does affect a patient's risk-adjustment score if the proper hierarchical condition category (HCC) codes are assigned.
A patient without a diagnosis of hypertension has presented on two prior occasions with elevated blood pressure. At the current encounter for an unrelated problem, knee pain, her blood pressure is again elevated after being measured twice, but she states that it is not elevated when she measures it elsewhere.
That means if elevated blood pressure is the documented reason for the check by clinical staff and the reading is abnormal, a code for hypertension cannot be assigned without appropriate documentation by a physician or other qualified health care professional. Scenario: Normal blood pressure check.
Controlling high blood pressure is a high-priority measure in the Medicare Merit-Based Incentive Payment System (MIPS). Family physicians in small practices (no more than 15 eligible clinicians/NPIs) can report this measure on claims using the following HCPCS codes.
To report hypertensive heart disease, use a code from category I11 (e.g., I11.0, “ Hypertensive heart disease with heart failure”) and report a code for the type of heart failure (e.g., I50.32, “Chronic diastolic heart failure”).