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ICD-10 Guide
ICD-10 CodesI27.2

I27.2

Non-billable

Other secondary pulmonary hypertension

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I27.2 is a used to indicate a diagnosis of other secondary pulmonary hypertension.

Key Diagnostic Point:

I27.2 refers to other secondary pulmonary hypertension, a condition characterized by elevated blood pressure in the pulmonary arteries due to various underlying health issues. This form of pulmonary hypertension can arise from chronic conditions such as left heart disease, lung diseases (like COPD or interstitial lung disease), or chronic thromboembolic disease. Clinically, patients may present with symptoms including dyspnea on exertion, fatigue, chest pain, and syncope. The anatomy involved primarily includes the pulmonary arteries and the right side of the heart, which must work harder to pump blood through the narrowed vessels. Disease progression can lead to right heart failure if left untreated, as the right ventricle becomes strained. Diagnostic considerations include echocardiography, right heart catheterization, and imaging studies to identify the underlying cause of the hypertension. Accurate diagnosis is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation of underlying conditions.
  • Treatment complexity: Management may involve multiple specialties and therapies.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other types of pulmonary hypertension.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of pulmonary hypertension.
  • Documentation gaps: Incomplete records regarding underlying conditions.
  • Billing challenges: Potential denials if the underlying cause is not well-documented.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Pulmonology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I27.2 lies in its association with serious health conditions that can lead to increased morbidity and mortality. Understanding and managing secondary pulmonary hypertension is crucial for improving patient outcomes and reducing healthcare utilization. Population health impact includes the need for coordinated care among various specialties, as well as the importance of early diagnosis and intervention to prevent progression to right heart failure.

ICD-9 vs ICD-10

The clinical significance of I27.2 lies in its association with serious health conditions that can lead to increased morbidity and mortality. Understanding and managing secondary pulmonary hypertension is crucial for improving patient outcomes and reducing healthcare utilization. Population health impact includes the need for coordinated care among various specialties, as well as the importance of early diagnosis and intervention to prevent progression to right heart failure.

Reimbursement & Billing Impact

Reimbursement may depend on the clarity of the documentation and the specificity of the coding. Common denials can occur if the documentation does not adequately support the diagnosis or if the underlying condition is not clearly identified. Best practices include ensuring that all relevant clinical findings and diagnostic tests are documented and that coding is precise to avoid billing issues.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I27.2?

I27.2 encompasses pulmonary hypertension secondary to conditions such as left heart failure, chronic lung diseases, and pulmonary embolism. It is essential to document the specific underlying condition contributing to the pulmonary hypertension.

When should I27.2 be used instead of related codes?

I27.2 should be used when pulmonary hypertension is secondary to other health conditions, as opposed to primary pulmonary hypertension (I27.0), which has no identifiable cause. Accurate differentiation is crucial for appropriate treatment and reimbursement.

What documentation supports I27.2?

Documentation should include a comprehensive assessment of the patient's medical history, diagnostic tests confirming pulmonary hypertension, and identification of the underlying condition. This may involve echocardiograms, right heart catheterization results, and notes from consultations with specialists.