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.**
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, 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
