ICD Hypertensive cerebrovascular disease guidlines

[Chaim]

In icd-9-cm guidlines -- I.C.7.a.5 -- Hypertensive cerebrovascular disease, it states to first assign codes from 430-438, then the appropriate code from categories 401-405, but in category 401 within the excludes list, it says "that invlolving vessels of - brain (430-438).

I remember reading that chapter specific guidelines take precedence over regular guidlines. Am I correct? And if so, does that mean do not use category 401 with categories 430-438?

Thanks,

Chaim

 

[Chaim]

Spelling error guidlines -- correction -- guidelines.

 

[Alicia Scott]

Chaim I reached for my manual and actually had it open to 401 which I thought was rather funny. I have this figured out now and hope that I can articulate it well enough here. Needed to have a good nights sleep to see it clearer after the Thursday night student call.
So, the Guideline you mention I.C.7.a.5 -- Hypertensive cerebrovascular disease, it states to first assign codes from 430-438, then the appropriate code from categories 401-405, is speaking in broad terms. It is stating that from the "section" HYPERTENSIVE DISEASE (401-405)

Then you break down under 401 and get additional instruction that states for 401 Essential hypertension there is an Excludes and this excludes applies to 401 codes in the 401-405 indention/subcategory only. When you move down to the other categories in the range of 401-405 you don't see this excludes notation. That is what we go by.

A real world example would be:
You are driving down an interstate and approaching a toll booth. A sign tells you that if you have a toll pass use lanes 1 and 2. When you arrive at the toll booth another sign tells you that if you are a truck/multi axil you must go through lane 1.

So the manual is working like a funnel narrowing the guidelines to get the highest specificity. The I.C.7.a.5 is a broad guideline and when you get to the range in the Tabular it is narrowed even more.

Another reason is looking at it backwards. 430-438 is not going to be normal ole 401 HTN. It is a different type. It is going to be a 402 or a 404.

Thanks again for posting this question here. Now we can refer people here if the question comes up again.

 

[Chaim]

Makes sense Alicia

Thanks!