I16.1 — Hypertensive emergency
I16.1 is a billable, specific ICD-10-CM code for hypertensive emergency. It is valid for submission on a claim.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable, to identify specific organ dysfunction, such as:
- acute kidney injury (N17.-)
- acute myocardial infarction (I21.-)
- acute pulmonary edema (left and/or right ventricular failure) (J81.0, I50.-)
- aortic dissection (I71.0-)
- cerebral hemorrhage (I60.-. I61.-, I62.-)
- cerebral infarction (I63.-)
- eclampsia (O15.-)
- hypertensive encephalopathy (I67.4)
- seizure (R56.9)
Risk adjustment
I16.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
I16.1 is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56605Billing and Coding: B-type Natriuretic Peptide (BNP) Testing
- A56625Billing and Coding: Echocardiography
- A56758Billing and Coding: Non-Invasive Vascular Studies
How I16.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I16.1.
- Hypertension, hypertensive›emergency
Related codes at this level
Codes that share I16. If I16.1 is not quite right, the correct code is usually one of these.
Questions about I16.1
- Is I16.1 a billable ICD-10-CM code?
- Yes. I16.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I16.1 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Hypertensive diseases (I10-I1A).