According to the Cleveland Clinic, “Pulmonary hypertension is a rare lung disorder in which the arteries that carry blood from the heart to the lungs become narrowed, making it difficult for blood to flow through the vessels”.
As a result, the blood pressure in these arteries, called pulmonary arteries, rises far above normal levels. This abnormally high pressure strains the right ventricle of the heart, causing it to expand in size. Overworked and enlarged, the right ventricle gradually becomes weaker and fails to pump enough blood to the lungs. This process can lead to the development of right heart failure.
Pulmonary hypertension occurs in individuals of all ages, races and ethnic backgrounds. Although, it is more common in young adults and is approximately twice as common in women as in men. The symptoms of pulmonary hypertension range in severity, and not every patient has every symptom. Usually, the symptoms do not occur in a patient until the disease has progressed.
There are 5 pulmonary hypertension groups:
Historically, coders most often assigned code I27.20 pulmonary hypertension unspecified or NOS due to lack of further specification from the physician. However, we are seeing a new trend in physician documentation where they are starting to document the groups of pulmonary hypertensions. Therefore, when coding pulmonary hypertension always make sure to not default to I27.20 and take the extra time to review the documentation for specificity of the stage.
Alicia R. Blamble, RHIA
Managing Auditor, Excite Health Partners