Definition of Hypertensive Crisis

Hypertensive crisis is a severe, rapid elevation of blood pressure characterized by systolic readings of 180 mmHg or higher, or diastolic readings of 120 mmHg or higher. This condition poses a significant risk to vital organs, including the heart, brain, kidneys, and eyes, and can precipitate life-threatening events such as stroke or heart attack.

Clinical Presentation

Patients experiencing hypertensive crisis may exhibit a range of symptoms, including:

• Severe chest pain or shortness of breath
• Intense headache accompanied by visual disturbances, confusion, or seizures
• Nausea and vomiting
• Altered mental status (e.g., unresponsiveness)
• Epistaxis (nosebleed)
• Excessive anxiety
• Edema (swelling)

Classification of Hypertensive Crisis

Hypertensive crisis is categorized into two primary types:

• Hypertensive urgency: Elevated blood pressure without evidence of acute organ damage.
• Hypertensive emergency: Elevated blood pressure with acute organ dysfunction.

ICD-10-CM Coding

The ICD-10-CM classification system provides specific codes for hypertensive crisis and its subtypes:

Coding Guidelines:

• Code first: Any identified underlying hypertensive condition (e.g., I10-I15, I1A) should be coded prior to the hypertensive crisis code.
• Resistant hypertension: If present, code I1A.0 (Resistant hypertension) should be sequenced before codes from categories I10-I15.

Accurate coding of hypertensive crisis is essential for patient care and reimbursement. Coders must carefully review medical documentation to determine the appropriate code based on the patient’s clinical presentation and severity of the condition.