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Assign hypertension (arterial) (essential) (primary) (systemic) (NOS) to category code 401 with the appropriate fourth digit to indicate malignant (.0), benign (.1), or unspecified (.9). Do not use either .0 malignant or .1 benign unless medical record documentation supports such a designation. Certain heart conditions (425.8, 428, 429.0-429.3, 429.8, 429.9) are assigned to a code from category 402 when a causal relationship is stated (due to hypertension) or implied (hypertensive). Use only the code from category 402. The same heart conditions (425.8, 428, 429.0-429.3, 429.8, 429.9) with hypertension, but without a stated casual relationship, are coded separately. Sequence according to the circumstances of the admission. Assign codes from category 403, Hypertensive renal disease, when conditions classified to categories 585-587 are present. Unlike hypertension with heart disease, ICD-9-CM presumes a cause-and-effect relationship and classifies renal failure with hypertension as hypertensive renal disease. Assign codes from combination category 404, Hypertensive heart and renal disease, when both hypertensive renal disease and hypertensive heart disease are stated in the diagnosis. Assume a relationship between the hypertension and the renal disease, whether or not the condition is so designated. First assign codes from 430-438, Cerebrovascular disease, then the appropriate hypertension code from categories 401-405. Two codes are necessary to identify the condition. First assign the code from subcategory 362.11, Hypertensive retinopathy, then the appropriate code from categories 401-405 to indicate the type of hypertension. Two codes are required: one to identify the underlying condition and one from category 405 to identify the hypertension. Sequencing of codes is determined by the reason for admission to the hospital. Assign code 796.2, Elevated blood pressure reading without diagnosis of hypertension, unless patient has an established diagnosis of hypertension. Assign code 642.3x for transient hypertension of pregnancy. Assign appropriate code from categories 401-405. This diagnostic statement usually refers to an existing state of hypertension under control by therapy. Uncontrolled hypertension may refer to untreated hypertension or hypertension not responding to current therapeutic regimen. In either case. assign the appropriate code from categories 401-405 to designate the stage and type of hypertension. Code to the type of hypertension.
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