Chapter-9

DISEASES OF THE
CIRCULATORY SYSTEM(I00-I99)
• HYPERTENSION:

 High blood pressure = hypertension

 Types are:
1. Primary hypertension. I10
2. Secondary hypertension: caused by another medical condition.I15
3. Complicated hypertension:
If left untreated it leads to arteriosclerosis(angina, myocardial infarction) , heart
failure, cerebrovascular accident (stroke), enlarged heart, kidney damage.
Hypertension with heart diseases:

1. I 11 (Hypertensive heart disease)

2. I50, I51.4… (type of heart failure)

If unrelated heart condition:

1. I50, I51,…
2. I10 for hypertension
SEQUENCED according to encounter.
• Hypertension with CKD: S1-N18.1
S2-N18.2
• Hypertension with CKD: S3-N18.3
S4-N18.4
1. I12
2. N18.1 S5-N18.5
ESRD-N18.6
If unrelated to the hypertension”
3. N18.1
4. I10
5. Code for acute renal faliure
• If the document shows a patient has hypertensive heart disease and CKD.
1.I13
2.N18
3.I50,I51..

IF unrelated to hypertension:
1. I51…
2. N18..
3. I10
4. I50, N17.9

• Secondary hypertension :
1.The aetiology
2. I15
Hypertensive Cerebrovascular Disease
1. I60
2. Hypertension code(I10,..
sequalae: 1. I69 (neurological deficit)
2. I160-I167 (causes of sequalae)

Hypertensive Retinopathy
3. H35.0
4. Hypertension code(I10,..

Hypertension, Transient
R03.0
O13. , O14.

Hypertensive Crisis
5. I16
6. Hypertension code(I10,..
MYOCARDIAL INFARCTION(MI)
• Commonly called as heart attack
• Occurs when blood flow decreases or stops to a part of heart,causing
damage to heart muscle.
• Types of mi :
1. St-elevated(stemi):most dangerous coronary artery completely blocked
,st segment elevated.All heart muscle supplied by affected artery starts
to die
2. St-non-elevated(non-stemi or n-stemi):blood clot partially occludes the
artery and only the portion of heart muscle affected by the arteries die.
 GUIDELINES
• If during the encounter stemi converts to non-stemi or non-stemi
converts to stemi, report the code for stemi.

• If type of mi is not documented as stemi or non-stemi.Consider it

as stemi.

• If no care or treatment is required that mi is considered as

old/healed stemi
SUBSEQUENT STEMI
• Code for subsequent stemi is reported when a patient has
suffered an mi(acute mi) within 4 weeks from initial mi
1. I22
2. I12.
QUESTIONS
1. Hypertension
2. Hypertensive heart diseases with acute diastolic heart failure
3. If patient is admitted for the treatment of stge 4 ckd due to hypertension
4. Hypertensive heart disease with ckd.
5. Patient is admitted for the treatment of hypertensive heart disease with
chronic systolic heart failure and end stage of renal disease.
6. Secondary hypertension
7. Myocardial infarction
8. Healed mi
9. Patient is admitted for the treatment of stemi of anterior wall . the patient
had a stemi involving right coronary artery
ANSWER

1. I10
2. I11.0,I50.31
3. I12.9,N18.4
4. I13.10,N18.9
5. I13.2,N18.6,I50.22
6. I15.9
7. I21.9
8. I25.2
9. I21.09,I21.11