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v1.0.0
ICD-10 Guide
DiagnosesHypertensive Encephalopathy

Hypertensive Encephalopathy

ICD-10 Coding for Hypertensive Encephalopathy(I67.4)

PRIMARY SPECIALTYEmergency Medicine
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Hypertensive Encephalopathy?
Essential facts and insights about Hypertensive Encephalopathy

Key Clinical Considerations:

  • Severe headache
  • Altered mental status
  • Seizures
  • Visual disturbances
  • Nausea and vomiting

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of hypertension
  • Neurological assessment findings
  • Blood pressure readings at presentation
  • Evidence of end-organ damage

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding hypertensive emergencies.
  • Common errors include misclassifying as stroke or other neurological conditions.

Code Exclusions

Important Exclusions

  • Cerebrovascular accident (CVA)
  • Hypertensive heart disease
  • Secondary hypertension

Related ICD-10 Codes

Primary Codes
I67.4
Hypertensive encephalopathy
Ancillary Codes
I16.1
Differential Codes
G93.40
G93.40
when the cause of encephalopathy is not specified or not related to hypertension.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Emergency Medicine

Specialty Applications

  • Patients with a history of uncontrolled hypertension
  • Emergency department settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document all clinical findings, vital signs, and treatment provided.

What are the billing considerations?

Ensure accurate coding of hypertensive crisis and associated symptoms.