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The ICD-10-CM category I16 includes specific codes for hypertensive crises, allowing coders to distinguish between hypertensive urgency (I16.0), hypertensive emergency (I16.1), and unspecified hypertensive crisis (I16.9). This differentiation facilitates accurate tracking of patients requiring immediate treatment for clinically significant hypertension. Note that accelerated or malignant hypertension should be coded using category I10-I15 instead.
Understanding Hypertensive Crisis
A hypertensive crisis involves a rapid and severe increase in blood pressure, with systolic readings of 180 mm Hg or higher, or diastolic readings of 120 mm Hg or higher. This condition can damage blood vessels, causing them to inflame and potentially leak fluid or blood, which impairs the heart's ability to pump effectively. Immediate evaluation is crucial to assess organ function and determine the appropriate treatment. Even without a hypertension diagnosis, a hypertensive crisis can occur at lower blood pressure levels.
Categories of Hypertensive Crisis
- Urgent: Extremely high blood pressure without suspected organ damage.
- Emergency: Extremely high blood pressure with confirmed organ damage.
Causes of Hypertensive Crisis
- Medication noncompliance or adverse reactions
- Stroke, myocardial infarction (MI), heart failure, renal failure
- Eclampsia during pregnancy
- Head injury
- Hormone imbalance
- Excessive sodium consumption
Signs and Symptoms
- Severe chest pain/shortness of breath
- Severe headache, potentially with blurred vision, confusion, or seizures
- Nausea and vomiting
- Unresponsiveness
- Nosebleed
- Marked anxiety
- Swelling/edema
While hypertensive crisis is rare in children, any sudden severe increase in a child’s blood pressure requires immediate intervention to prevent serious consequences.
Coding and Sequencing
When documentation supports using a code from category I16 for hypertensive crisis, the sequencing of codes depends on the circumstances of admission or the reason for the encounter. Additionally, coders should include any hypertensive disease codes from category I10-I15.
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The information contained in this blog post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
