Chapter_005课件.ppt

This chapter contains codes for diseases of the heart and blood vessels. Hypertension is one of the most common conditions coded in this chapter. Uncontrolled hypertension is considered malignant. The Hypertension Table is located in the Index and is shown in Fig. 5–2 of the text. The first category identifies the hypertensive condition, such as accelerated, antepartum, cardiovascular disease, cardiorenal, and cerebrovascular disease. The remaining three columns—malignant, benign, and unspecified—constitute the subcategories of hypertensive disease. Assign hypertension (arterial) (essential) (primary) (systemic) (NOS) to category code 401. Also, assign the appropriate fourth digit to indicate malignant, benign, or unspecified. Do not use malignant or benign unless the documentation supports this designation. Hypertensive heart disease refers to secondary effects on the heart of prolonged, sustained, or systemic hypertension. Heart conditions are assigned to a code from category 402 when a causal relationship is stated (due to hypertension) or implied (hypertensive). Use an additional code from category 428 to identify type of heart failure in those patients with heart failure. More than one code from category 428 may be assigned if the patient has systolic or diastolic failure and congestive heart failure. Assign codes from category 403, Hypertensive Renal Disease, when conditions classified to categories 585-587 are present. A fifth digit of 0 represents Renal Failure Stages I-IV or unspecified (585.1-585.4 and 585.9). A fifth digit of 1 represents Renal Failure Stage V or End Stage Renal Disease (585.5-585.6). Use additional code to identify the stage of chronic kidney disease (585.1-585.9) Assign codes from combination category 404, Hypertensive renal and heart disease, when both hypertensive renal disease and hypertensive heart disease are stated in the diagnosis. Assign a fifth digit to identify with/without heart failure and the stage of the renal failure.