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ICD-10 Guide
ICD-10 CodesI27.23

I27.23

Billable

Pulmonary hypertension due to lung diseases and hypoxia

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

Code Description

ICD-10 I27.23 is a billable code used to indicate a diagnosis of pulmonary hypertension due to lung diseases and hypoxia.

Key Diagnostic Point:

Pulmonary hypertension due to lung diseases and hypoxia is a condition characterized by elevated blood pressure in the pulmonary arteries, which can arise from various lung diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, and sleep apnea. The pathophysiology involves vascular remodeling and increased resistance in the pulmonary circulation, leading to right ventricular strain and potential heart failure. Clinically, patients may present with symptoms such as dyspnea, fatigue, chest pain, and syncope. The anatomy involved includes the pulmonary arteries, right ventricle, and the lung parenchyma. Disease progression can be insidious, often leading to severe complications if not diagnosed and managed appropriately. Diagnostic considerations include echocardiography, right heart catheterization, and pulmonary function tests to assess the underlying lung disease and the severity of pulmonary hypertension. Early identification and treatment are crucial to improve patient outcomes and quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of lung function and cardiac status.
  • Treatment complexity: Management may involve multiple specialties and therapies, including oxygen therapy, diuretics, and pulmonary vasodilators.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other types of pulmonary hypertension.

Audit Risk Factors

  • Common coding errors: Misclassification of pulmonary hypertension types.
  • Documentation gaps: Incomplete clinical notes regarding underlying lung disease.
  • Billing challenges: Denials due to insufficient evidence of hypoxia or lung disease.

Specialty Focus

Medical Specialties

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

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

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

Pulmonary hypertension due to lung diseases and hypoxia significantly impacts patient quality of life and healthcare utilization. It is associated with increased morbidity and mortality, necessitating comprehensive management strategies. Understanding the epidemiology of this condition is crucial, as it affects a substantial portion of patients with chronic lung diseases. Quality measures focusing on early diagnosis and effective management can improve outcomes and reduce hospitalizations.

ICD-9 vs ICD-10

Pulmonary hypertension due to lung diseases and hypoxia significantly impacts patient quality of life and healthcare utilization. It is associated with increased morbidity and mortality, necessitating comprehensive management strategies. Understanding the epidemiology of this condition is crucial, as it affects a substantial portion of patients with chronic lung diseases. Quality measures focusing on early diagnosis and effective management can improve outcomes and reduce hospitalizations.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the severity of the condition and the complexity of the treatment regimen. It is advisable to stay updated on payer-specific guidelines to optimize reimbursement.

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 I27.23?

I27.23 encompasses pulmonary hypertension secondary to chronic lung diseases such as COPD, pulmonary fibrosis, and conditions leading to hypoxia, including sleep apnea. It is essential to document the underlying lung disease to support the use of this code.

When should I27.23 be used instead of related codes?

I27.23 should be used when pulmonary hypertension is specifically due to lung diseases and hypoxia, distinguishing it from other forms of pulmonary hypertension such as those caused by left heart disease or chronic thromboembolic disease.

What documentation supports I27.23?

Documentation must include a clear diagnosis of pulmonary hypertension, evidence of underlying lung disease, and any relevant tests such as echocardiograms or pulmonary function tests that confirm the diagnosis and severity.