ICD-10-CM Code for Elevated Blood Pressure Without Hypertension Diagnosis
Use ICD-10-CM code R03.0 for an elevated blood pressure reading when hypertension has not been diagnosed. This code specifically captures situations where blood pressure is measured above normal but does not yet meet criteria for a formal hypertension diagnosis.
Understanding the Distinction
The key difference lies between a confirmed diagnosis of hypertension versus an isolated elevated reading:
- I10 is the ICD-10-CM code for confirmed essential (primary) hypertension 1
- R03.0 is the appropriate code for elevated blood pressure readings without an established diagnosis 1
When to Use R03.0
Use this code in the following clinical scenarios:
- Single elevated reading: When blood pressure is measured as elevated (SBP 120-129 mmHg with DBP <80 mmHg, or higher) but has not been confirmed on multiple occasions 1
- Awaiting confirmation: When out-of-office blood pressure monitoring (ABPM or HBPM) is needed to confirm the diagnosis before labeling the patient as hypertensive 1
- White coat effect suspected: When office readings are elevated but you suspect white coat hypertension and need confirmatory testing 1
- First presentation: When a patient presents with elevated BP for the first time and requires repeat measurements on separate days 1, 2
Diagnostic Confirmation Requirements
Before assigning a hypertension diagnosis code (I10), guidelines require:
- Multiple measurements: An average of ≥2 readings obtained on ≥2 separate occasions 1
- Proper technique: Measurements should follow standardized protocols (seated position, feet flat, back supported, arm at heart level, after 5 minutes of rest) 1
- Out-of-office confirmation: ABPM or HBPM is recommended to confirm diagnosis, particularly when SBP is 130-160 mmHg or DBP is 80-100 mmHg 1
Exception: Patients with blood pressure ≥180/110 mmHg and existing cardiovascular disease can be diagnosed with hypertension at a single visit 1
Clinical Pitfall to Avoid
Do not prematurely assign code I10 based on a single elevated reading, as this can lead to:
- Inappropriate medication initiation 1
- Insurance implications for the patient 1
- Misclassification of white coat hypertension (present in a significant proportion of patients with office readings in the 130-160/80-100 mmHg range) 1
Hypertensive Crisis Codes
For severely elevated blood pressure (>180/>120 mmHg), different codes apply 1, 3:
- I16.0: Hypertensive urgency (severe elevation without end-organ damage) 1, 4
- I16.1: Hypertensive emergency with target organ damage 1
- I16.9: Hypertensive crisis, unspecified 1
These codes are distinct from R03.0 and indicate more severe, acute presentations requiring immediate intervention 3, 4.