icd 9 code for white coat hypertension

What is diagnosis code 10?

Jun 10, 2015 · Answer: The best diagnosis code for white coat hypertension is 796.2 (Elevated blood pressure reading without diagnosis of hypertension). Per ICD-9, you should use this code to record an episode of elevated blood pressure in a patient for whom the physician hasn’t made a formal diagnosis of hypertension or as an incidental finding. The ICD-9 index lists it under …

What is ICD10 code for hypertension?

Short description: Elev bl pres w/o hypertn. ICD-9-CM 796.2 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 796.2 should only be used for claims with a date of service on or before September 30, 2015.

What is the ICD 10 code for accelerated hypertension?

Jun 27, 2014 · ICD-9-CM Official Guidelines for Coding and Reporting Effective October 1, 2011 Page 38 of 107 Hypertensive Chronic Kidney Disease Assign codes from category 403, Hypertensive chronic kidney disease, when conditions classified to category 585 or code 587 are present with hypertension. ICD-9-CM Official Guidelines for Coding and Reporting Effective …

What is the ICD 10 code for hypertensive emergency?

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 R90.82 [convert to ICD-9-CM] …

What is the ICD-10 code for white coat hypertension?

What is the ICD-10 code for elevated blood pressure?

What is the ICD-10 code for elevated blood pressure without hypertension?

What is the ICD-10 code for unspecified hypertension?

What is white coat hypertension?

What is the main term for elevated blood pressure reading?

What does secondary hypertension mean?

Is hypertensive disorder the same as hypertension?

How do you code secondary hypertension?

What is diagnosis code i50 9?

What is suspected white coat hypertension?

Suspected white coat hypertension – when a patient’s anxiety from being in a clinical setting causes their blood pressure to rise uncharacteristically – defined as office blood pressure ≥130/80 mm Hg and <160/100 mm Hg on at least two separate clinic/office visits with two separate measurements made at each visit after 3 months of behavioral interventions including diet and exercise modification and with at least two blood pressure measurements taken outside the office which are <130/80 mm Hg; or

When will Medicare cover ambulatory blood pressure monitoring?

Update: 05/2020 – For dates of service on and after July 2, 2019 , CMS will cover Ambulatory Blood Pressure Monitoring for the diagnosis of hypertension in Medicare beneficiaries under updated criteria. ( TN 10073) (CR11650)

What is white coat hypertension?

White-coat hypertension occurs in 15% to 30% of subjects with an elevated office blood pressure, 2, 3 and the phenomenon is reasonably reproducible. 2, 4 Although there are no pathognomonic diagnostic features of white-coat hypertension, this condition occurs more frequently in women, older adults, nonsmokers, recently diagnosed patients with hypertension with a limited number of conventional blood pressure measurements in the office setting who have mild hypertension, pregnant women, and subjects without evidence of target organ damage. 2, 5, 6 The misdiagnosis of subjects with white-coat hypertension as being truly hypertensive can result in them being penalized for employment and insurance rating, as well as being prescribed unnecessary lifelong treatment with potential side effects that may be seriously debilitating, especially in the elderly. Moreover, failure to identify the condition results in a large expenditure on unnecessary drugs. 7

What should clinicians know about white coat hypertension?

This review highlights what clinicians should know about white-coat hypertension. They should not confuse high-normal blood pressure with white-coat hypertension. They should be aware that untreated subjects with white-coat hypertension may still be at increased cardiovascular risk, albeit small compared with subjects with sustained hypertension, which will be dependent on associated cardiometabolic risk factors. For researchers of cardiovascular outcomes and health economists, our review highlights the necessity to define the risk associated with white-coat hypertension and to define a true low-risk normotensive comparator group. This includes elimination of subjects with prior cardiovascular events, target organ damage, cardiometabolic risk factors, and patients on antihypertensive drug treatment. Experts writing guidelines for the diagnosis and management of hypertension should examine carefully the definitions used to categorize patients with hypertension. As shown by the report of Sung et al, 18 not uniformly labeling categories of blood pressure ( Table 2) confuses both clinicians and researchers. Furthermore, expert committees should reflect outcome-driven 2, 17 rather than arbitrary thresholds for out-of-the-office blood pressure measurement, the diurnal intervals (24-hour versus daytime versus night-time) or the number of self-measurements to be considered to quantify the white-coat effect or to diagnose white-coat hypertension by ABPM or home blood pressure monitoring, respectively. Finally, in the presence of concurrent antihypertensive treatment, one should be cautious in applying the term white-coat hypertension to an individual with increased office blood pressure and normal ABPM. Thus, the determination of true white-coat hypertension requires a clear answer to the question: “compared to whom?”

What is the white coat effect?

28 – 30 The white-coat effect is a measure of blood pressure change from before to during the visit in office/clinic when the blood pressure is recorded by a physician or nurse; this was first described in 1983 by Mancia et al 31 with the use of cuff and intra-arterial bedside measurements. White-coat effect is present in almost all persons and can vary from minimal to marked in a given individual with an overall mean increase of 27 mm Hg systolic blood pressure. 31 The pathogenesis of white-coat effect is an alerting reaction working through reflex activation of the sympathetic nervous system. 32 The white-coat effect is more prominent in older people, women, and patients labeled (diagnosed) as hypertensive. 33 A clinically significant white-coat effect is an office or clinic blood pressure exceeding the daytime ABPM by 20 mm Hg systolic or 10 mm Hg diastolic, either in the absence or presence of antihypertensive drug treatment. 28 – 31 The white-coat effect might lead to subjects with normotension being classified as stage 1 or even stage 2 patients with hypertension, and stage 1 patients with hypertension being classified as stage 2 patients with hypertension.

What is ABPM in a patient with hypertension?

Patients whose conventional blood pressure remains uncontrolled by 3 classes of antihypertensive agents, including a diuretic, have so-called resistant hypertension. However, when ABPM is performed, in as many as one third of patients with apparent resistant hypertension, the resistance is a manifestation of conventional blood pressure measurement and ABPM levels are lower, showing that the blood pressure elevation is in fact a white-coat effect (see below). 20, 21 Characteristics of true resistant hypertension include male sex, longer duration of hypertension, a worse cardiovascular risk profile, smoking, diabetes mellitus, target organ damage, and a history of cardiovascular disease or chronic kidney disease. 20, 21 Importantly, the clinical picture alone does not distinguish between truly resistant and white-coat resistant hypertension, so that ABPM must be applied as a diagnostic and prognostic procedure in patients suspected of having resistant hypertension. 20, 21 Indeed, by establishing a diagnosis of white-coat resistant hypertension, one can simplify what may be excessive antihypertensive drug treatment.

What blood pressure should be excluded in an untreated patient?

The Task Force of the Eighth International Consensus Conference on Blood Pressure Monitoring 10 recommends ambulatory monitoring to exclude white-coat hypertension in untreated patients when (1) the office blood pressure is ≥140/90 mm Hg on ≥3 separate office visits; (2) ≥2 blood pressure measurements taken outside the office are <140/90 mm Hg, frequently using home blood pressure monitoring; and (3) there is no evidence of hypertensive target organ damage. For patients with a confirmed daytime ABPM of ≥135/85 mm Hg, physicians may wish to consider starting antihypertensive drug treatment. 10 The recent British National Institute for Health and Clinical Excellence (NICE) guidelines 11 advocate that every person with elevated office blood pressure aged >18 years undergo ABPM to rule out a diagnosis of white-coat hypertension with the potential for savings in health costs by virtue of unnecessary treatment with antihypertensive drugs.

How long does it take for ABPM to confirm white coat hypertension?

Once ABPM has confirmed the diagnosis of white-coat hypertension, the European Society of Hypertension Working Group on Blood Pressure Monitoring 2 recommends that the diagnosis be reconfirmed in 3 to 6 months and followed up yearly with ambulatory monitoring to detect any evidence of progression to sustained hypertension. 2

Does white coat hypertension lead to sustained hypertension?

In retrospect, the propensity of subjects with white-coat hypertension to progress to sustained hypertension may be associated with at least 3 clinical states: (1) those persons on the upper end of the blood pressure spectrum, that is, high-normal daytime ABPM, especially in the middle-aged and older group have the greatest propensity to develop sustained hypertension over a relatively short time; (2) subjects with night-time elevation in ABPM in association with normal/high-normal daytime ABPM of 130 to 135/80 to 85 mm Hg, often associated with obstructive sleep apnea, autonomic dysfunction, diabetes mellitus, or chronic kidney disease, 2, 17 might really have masked hypertension rather than white-coat hypertension; and (3) the high number and severity of cardiometabolic abnormalities associated with normal/high-normal ABPM values in persons with white-coat hypertension may predispose to increased cardiovascular disease risk over time (see below).