ICD Code I27.21

ICD code I27.21 is secondary pulmonary arterial hypertension, which refers to high blood pressure in the arteries of the lungs caused by another underlying condition, such as heart or lung disease.

1. Evidence of elevated pulmonary arterial pressure confirmed by right heart catheterization or echocardiography

2. Clinical signs and symptoms of pulmonary hypertension, such as dyspnea, fatigue, chest pain, or syncope

3. Documentation of an underlying condition known to cause secondary pulmonary arterial hypertension (e.g., left heart disease, chronic lung disease, chronic thromboembolic disease, connective tissue disorders, or congenital heart disease)

4. Exclusion of primary (idiopathic) pulmonary arterial hypertension

5. Radiologic or laboratory findings supporting secondary causes, such as abnormal chest imaging, pulmonary function tests, or serologic markers

6. Absence of significant left-sided heart disease as the primary cause of symptoms

7. Chronicity of symptoms and hemodynamic findings consistent with a secondary etiology

Relevant CPT codes that may be used to treat ICD code I27.21 include:

- 93451: Right heart catheterization

- 93452: Left heart catheterization

- 93453: Combined right and left heart catheterization

- 92960: Cardioversion, elective, external

- 96372: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

- 96401-96417: Chemotherapy administration (if applicable for certain treatments)

- 99221-99223: Initial hospital care, per day, for the evaluation and management of a patient

- 99231-99233: Subsequent hospital care, per day, for the evaluation and management of a patient

- 99291-99292: Critical care, evaluation and management of the critically ill or critically injured patient

Selection of CPT codes should be based on the specific services rendered for patients with ICD code I27.21.

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