Katie Brown, CCS • August 11, 2025

Hypertensive Emergency: ICD-10-CM FY 2025 Sequencing and Coding Guidance

What Is a Hypertensive Emergency?

Hypertensive Emergency is a severe increase in high blood pressure (typically greater than 180 systolic/120 diastolic) with potentially life-threatening symptoms or damage to vital organs. 


**In FY 2025, new sequencing instructions were added to ICD-10 for hypertensive emergency.** 

ICD-10-CM Tabular List entry for I16.1 hypertensive emergency showing the “Use additional code” instruction

The Tabular List “Use Additional code” instructional note for hypertensive emergency must be followed when supported in documentation, which includes CDI query responses.  Hypertensive emergency I16.1 is appropriately sequenced as Principal Dx if an associated organ dysfunction / manifestation is documented. 


Documentation and Cause-and-Effect Considerations

Cause-Effect documentation may be in one concise statement or  within the context of several narrative statements indicating CVA, CHF exacerbation, etc. is a manifestation of hypertensive emergency. 

{Code also any identified hypertensive disease (I10-I15, I1A) as instructed by ICD-10 tabular}. 


 

Katie Brown, CCS, Senior Consultant, Audit at UASI

Katie Brown, CCS 

Senior Consultant, Audit at UASI


Katie Brown, CCS, is an AHIMA-certified Senior Coding Consultant specializing in CPT/ICD-10 coding, compliance audits, and revenue cycle support. She’s worked across diverse outpatient and inpatient settings, including ER, surgery, observation, and specialty clinics, and enjoys training coders with practical, CDI-friendly tips. 


Works Cited

BMJ Best Practice. (2025). Hypertensive emergencies: Symptoms, diagnosis, and treatment. Available at:
https://bestpractice.bmj.com/topics/en-us/27


Centers for Disease Control and Prevention. (2025). ICD-10-CM Tabular List of Diseases and Injuries. Available at:
https://www.cdc.gov/nchs/icd/icd-10-cm/index.html


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