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2025 ICD-10-CM code I67.4

Hypertensive encephalopathy. This condition involves brain dysfunction or damage resulting from sustained malignant hypertension.

Use additional codes to identify the presence of conditions like alcohol abuse (F10.-), tobacco use (Z72.0), hypertension (I10-I1A), and exposure to environmental tobacco smoke (Z77.22). Do not use this code with traumatic intracranial hemorrhage (S06.-) or if there is occlusion or stenosis causing cerebral infarction (I63.-).

The medical necessity for treating hypertensive encephalopathy stems from the potentially life-threatening nature of the condition.Severe hypertension can lead to cerebral edema, stroke, and other serious complications. Prompt diagnosis and treatment are essential to reduce morbidity and mortality.

Physicians diagnosing and managing hypertensive encephalopathy typically include neurologists, internists, emergency medicine physicians, and critical care specialists. They are responsible for evaluating the patient's neurological status, controlling blood pressure, managing associated complications, and providing supportive care.

In simple words: Hypertensive encephalopathy is a serious condition where very high blood pressure causes problems in the brain.Symptoms can include bad headaches, feeling sick, throwing up, seizures, confusion, and even coma.This happens because the high blood pressure damages blood vessels in the brain, preventing enough oxygen from getting to the brain cells.

Hypertensive encephalopathy is a medical condition characterized by brain dysfunction or damage caused by severely elevated blood pressure. When blood pressure surpasses the brain's autoregulation capacity, cerebral blood flow is compromised, leading to cerebral ischemia. Clinical manifestations include headaches, nausea, vomiting, seizures, altered mental state (potentially progressing to coma), papilledema, and retinal hemorrhage.It's crucial to code any associated hypertensive conditions like essential hypertension (I10), hypertensive chronic kidney disease (I12.-), hypertensive heart and chronic kidney disease (I13.-), or hypertensive heart disease (I11.-).Conditions like transient cerebral ischemic attacks (G45.-), certain conditions originating in the perinatal period (P04-P96), certain infectious/parasitic diseases (A00-B99), complications of pregnancy (O00-O9A), congenital malformations (Q00-Q99), endocrine/nutritional/metabolic diseases (E00-E88), injury/poisoning (S00-T88), neoplasms (C00-D49), other symptoms/signs (R00-R94), and systemic connective tissue disorders (M30-M36) are excluded.

Example 1: A patient presents to the emergency room with a severe headache, confusion, and vomiting. Their blood pressure is extremely high.A CT scan rules out other causes of their symptoms, and the diagnosis of hypertensive encephalopathy is made. The patient is admitted to the ICU for blood pressure management and supportive care., A patient with a history of poorly controlled hypertension experiences a seizure. Upon arrival at the hospital, they are found to have significantly elevated blood pressure and altered mental status.Hypertensive encephalopathy is suspected, and treatment is initiated to lower their blood pressure and stabilize their condition., A pregnant woman in her third trimester develops preeclampsia with severe hypertension. She experiences headaches, visual disturbances, and altered mental status. She is diagnosed with hypertensive encephalopathy and receives emergency treatment to control her blood pressure and protect both her and the fetus.

Documentation should include details of the elevated blood pressure readings, neurological symptoms (e.g., headache, confusion, seizures, altered mental status), any associated conditions (e.g., preeclampsia, chronic kidney disease), imaging results (e.g., CT scan, MRI), and treatment provided to lower blood pressure and manage the encephalopathy.

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