401.9 is not the only HTN code

I recently received a stressed email from a clinician confused about the use of 401.9. A doctor told her he wanted her to use 401.1, benign hypertension, rather than 401.9, which is hypertension NOS, for a patient. The clinician then tried to use 403.9, which software rejected, when coding unspecified hypertensive renal disease.

The correct coding lies in documentation. 401.9 can be used if the doctor does not specify whether the HTN is benign or malignant. If you have documented benign hypertension, and the hypertension is not linked to chronic kidney disease or heart disease, code 401.1.
Categories 402 and 403 deal with hypertension in combination with other diseases. 402.1x deals with benign hypertensive heart disease (the fifth digit indicates whether there is heart failure), and 403.1 addresses benign hypertensive chronic kidney disease. Don’t forget to add the stage of kidney disease after the 403 code.

If the patient has HTN and CKD, the hypertension is automatically considered hypertensive chronic kidney disease and is coded with a code from the 403 category. The 403 codes require 5 digits, but you coded with four digits, and that is why your software wouldn’t accept 403.9.

Always, always check the highest specificity to make sure your codes are valid. Query your docs for more specific disease information.

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