Pulmonary Hypertension

There’s a revised clinical classification for pulmonary hypertension (Venice 2003) that separates the causes of the disease into those affected by the pulmonary arterial tree, the pulmonary venous system and because of alterations in lung structure or function. I’ve forwarded the info for inclusion in the Spring C&M agenda, so we can hopefully see changes by Oct ‘08.I’ve always suspected that the administrative data associated with 4160 and 4168 was inconsistent and unreliable. After reading this SCCM article, I’m convinced that some of the new pulmonary hypterension codes will be distributed among all SOI levels (major CC, cc and non-cc). It’s pretty obvious that these codes need to be updated. Also it looks like the I-10 codes were just copied from I-9, so maybe we do need to wait for I-11. At any rate, treating pulmonary hypertension is a difficult management decision in the critical care unit.

ICD-10-CM

I27 Other pulmonary heart diseases
I27.0 Primary pulmonary hypertension
Pulmonary (artery) hypertension (idiopathic)(primary)
I27.1 Kyphoscoliotic heart disease
I27.8 Other specified pulmonary heart diseases
I27.9 Pulmonary heart disease, unspecified
Chronic cardiopulmonary disease
Cor pulmonale (chronic) NOS

ICD-9-CM

416 Chronic pulmonary heart disease
416.0 Primary pulmonary hypertension
Idiopathic pulmonary arteriosclerosis
Pulmonary hypertension (essential) (idiopathic) (primary)
416.1 Kyphoscoliotic heart disease
416.8 Other chronic pulmonary heart diseases
Pulmonary hypertension, secondary
416.9 Chronic pulmonary heart disease, unspecified
Chronic cardiopulmonary disease
Cor pulmonale (chronic) NOS

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