As a medical coding auditor with 12+ years of experience, I’ve resolved $ 1 M+ in denied claims due to incorrect hypertension coding. Let’s break down ICD-10 codes for high blood pressure, including tricky cases like pregnancy and unspecified readings, with real-world examples to keep your claims clean.
The primary code for essential hypertension is I10. However, coding varies based on specificity:
Example: A patient with chronic high BP and no complications = I10.
Case Study: A Texas clinic reduced denials by 30% by switching from R03.0 to I10 for confirmed hypertension cases.
Critical Rule: Always link pregnancy codes to trimester (e.g., O13.2 for third trimester).
Use R03.0 when:
Example: A patient’s BP spikes due to pain (R03.0 + pain code).
Documentation Tip: Note symptoms like chest pain (I16.1 + R07.9) or blurred vision (I16.1 + H53.8).
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E78.0 (pure hypercholesterolemia) or E78.5 (hyperlipidemia).
O26.21 (postpartum condition) + I10 if chronic.
No use O13/O14 for pregnancy-related cases
I11.0 (if heart failure is present) or I11.9 (if heart failure is not present).
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