2025 ICD-10-CM code I27.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Pulmonary heart disease and diseases of pulmonary circulation - Other pulmonary heart diseases IX Diseases of the circulatory system Feed
Primary pulmonary hypertension is a rare condition where blood pressure in the arteries of the lungs becomes abnormally high.
Medical necessity for coding I27.0 is established by clinical findings consistent with primary pulmonary hypertension.This typically involves objective evidence of elevated pulmonary artery pressure, right ventricular hypertrophy, and symptoms such as dyspnea, chest pain, and fatigue.The diagnosis is usually confirmed by right heart catheterization, echocardiography and may involve genetic testing in certain cases to rule out heritable forms of the disease. Treatment is aimed at improving symptoms, slowing disease progression, and improving survival, thereby meeting medical necessity criteria.
The clinical responsibility for a patient with I27.0 includes comprehensive evaluation, diagnosis, and management of the condition. This involves obtaining a detailed history including family history, conducting physical examinations, ordering appropriate diagnostic tests (e.g., echocardiography, cardiac catheterization, right heart catheterization, genetic testing), and initiating treatment strategies to manage the elevated pulmonary artery pressure.Ongoing monitoring and adjustment of treatment plans are crucial for the long-term management of this disease.
- IX Diseases of the circulatory system
- Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
In simple words: Primary pulmonary hypertension is a serious lung condition where the blood pressure in the blood vessels of your lungs gets too high.This isn't caused by another illness and can lead to heart problems.
I27.0, Primary pulmonary hypertension, is an ICD-10-CM code that classifies a rare disease characterized by elevated blood pressure in the pulmonary arteries.This increase in pressure is not caused by other underlying conditions, such as heart or lung disease.It can be hereditary (heritable pulmonary arterial hypertension), idiopathic (idiopathic pulmonary arterial hypertension), or of other primary origin. The condition can lead to right-sided heart failure.This code is specifically for primary pulmonary hypertension and excludes conditions such as persistent pulmonary hypertension of the newborn, unspecified pulmonary hypertension, and secondary pulmonary hypertension.Appropriate documentation should include details about the patient's symptoms, diagnostic findings (e.g., right heart catheterization results), family history of pulmonary hypertension, and any genetic testing performed.
Example 1: A 30-year-old female presents with progressive dyspnea, fatigue, and chest pain.Echocardiography reveals right ventricular hypertrophy and elevated pulmonary artery pressure. Right heart catheterization confirms primary pulmonary hypertension.Genetic testing is negative for familial forms of PAH., A 45-year-old male with a family history of pulmonary hypertension presents with symptoms of fatigue and exertional dyspnea.He undergoes diagnostic testing, including a right heart catheterization and genetic testing, which reveals a mutation in the BMPR2 gene consistent with heritable pulmonary arterial hypertension., A 25-year-old female experiences increasing shortness of breath and syncope.She undergoes comprehensive evaluation, including echocardiogram and right heart catheterization, revealing primary pulmonary hypertension. The physician initiates treatment with pulmonary vasodilators and oxygen therapy.
Thorough documentation is crucial for accurate coding of I27.0. Required documentation should include:*Detailed patient history, including family history of pulmonary hypertension.*Physical examination findings, specifically noting signs of right heart failure.*Results of diagnostic tests such as echocardiography, cardiac catheterization, and possibly genetic testing.*Documentation of treatment plans, including medications, oxygen therapy, and other interventions.*Regular follow-up notes detailing the patient's response to treatment and any changes in their condition.
** The diagnosis of primary pulmonary hypertension often requires a multidisciplinary approach, involving pulmonologists and cardiologists.Careful differentiation from secondary forms of pulmonary hypertension is vital for appropriate code selection and treatment planning.The severity of primary pulmonary hypertension can vary greatly, necessitating individualized treatment plans.
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