I27.22

HCC Category Mapping

What This Code Means

High blood pressure in the lung arteries that develops as a result of heart failure or other left-sided heart diseases.

Coding Tips

• •Always code the underlying left heart disease (such as heart failure or mitral valve disease) in addition to this code
• •This is a consequence of left heart dysfunction; ensure the primary cardiac condition is documented and coded

Clinical Significance

Pulmonary hypertension due to left heart disease is the most common form of pulmonary hypertension, typically resulting from heart failure with reduced or preserved ejection fraction or valvular heart disease. This code captures the cardiopulmonary continuum of disease and indicates advanced cardiac disease requiring complex management.

Documentation Requirements

• ✓Provider diagnosis of pulmonary hypertension secondary to left heart disease
• ✓Documented underlying left heart condition (heart failure, mitral valve disease, aortic valve disease)
• ✓Echocardiographic or catheterization evidence of elevated pulmonary pressures
• ✓Causal relationship between the left heart disease and pulmonary hypertension documented
• ✓Left ventricular ejection fraction and diastolic function assessment

Commonly Confused Codes