TheInternational Classification of Diseases, 10thEdition, Clinical Modification (ICD-10-CM)Code I16.0 Accurately Identifies Patients with Hypertensive Urgency

Abstract

ABSTRACTObjectiveHypertensive urgency, defined as acutely elevated BP without target organ damage, is associated with an increased risk of adverse cardiovascular events and accounts for a substantial proportion of national emergency department (ED) visits. To advance research in this space, we sought to validate the newICD-10-CMdiagnostic code for hypertensive urgency within a single healthcare system.MethodsWe performed a retrospective chart-review study of ED encounters at Weill Cornell Medicine from 2016 – 2021. We randomly selected 25 encounters with theICD-10-CMcode I16.0 as the primary discharge diagnosis and 25 encounters with primaryICD-10-CMdischarge diagnosis codes for benign headache disorders. A single board-certified vascular neurologist reviewed all 50 encounters while blinded to the assignedICD-10-CMcodes to identify cases of hypertensive urgency. We calculated the sensitivity, specificity, and positive predictive values of theICD-10-CMcode I16.0 with 95% confidence intervals (CI).ResultsOut of 50 randomly selected ED encounters, 24 were adjudicated as hypertensive urgency. All encounters adjudicated as hypertensive urgency had been assigned theICD-10-CMdischarge diagnosis code of I16.0. All 25 of the encounters adjudicated as headache were assigned anICD-10-CMdischarge diagnosis code for a benign headache disorder. TheICD-10-CMcode for hypertensive urgency, I16.0, was thus found to have a sensitivity of 100% (95% CI: 86-100%), specificity of 96% (95% CI: 80-100%), and positive predictive value of 96% (95% CI: 78-99%).ConclusionWe found that the newICD-10-CMcode for hypertensive urgency, I16.0, can reliably identify patients with this condition.