orthostatic hypotension...hypotension
Hi,
This is something that has been on my mind for a while...interested in other's vantage point.
Orthostatic hypotension-per Merck- Orthostatic (postural) hypotension is an excessive fall in BP when an upright position is assumed. The consensus definition is a drop of > 20 mm Hg systolic, 10 mm Hg diastolic, or both. Symptoms of faintness, light-headedness, dizziness, confusion, or blurred vision occur within seconds to a few minutes of standing and resolve rapidly on lying down. Some patients experience falls, syncope (see Syncope), or even generalized seizures. Exercise or a heavy meal may exacerbate symptoms. Most other associated symptoms and signs relate to the cause. Orthostatic hypotension is a manifestation of abnormal BP regulation due to various conditions, not a specific disorder.
SOOOOO... if a patient is hypotensive when the enter the care arena while in a recumbent position, it isn't surprising it drops more with a change of position.
Frequently orthostatic hypotension is documented only. As it is a stand alone diagnosis, it seems that BOTH hypotension AND orthostatic hypotension could be coded, and selection of principal could be either. ( I agree querying for dehydration may also be appropriate and may direct the PDX, but I am merely trying to see if anyone has had discussion on the subject of coding both orthostatic hypotension AND hypotenstion).
My current situation is one that the pt just discharged day before for admit for same reason. the bp was 90 lying dropped to 80. which technically isn't a drop of 20mm HG AND they were dizzy lying as well it just got worse..... AND they are an ESRD pt (which is what I am trying help be captured).
I was thinking of querying...
-Dehydration causing hypotension AND orthostatic hypotension
-Hypotension AND orthostatic hypotension, cause unknown
-Orthostatic hypotension only, BP low ONLY with position change. Not hypotensive otherwise/ orthostatic hypotension only
- other
-unable to determine
Thanks for your thoughts!
This is something that has been on my mind for a while...interested in other's vantage point.
Orthostatic hypotension-per Merck- Orthostatic (postural) hypotension is an excessive fall in BP when an upright position is assumed. The consensus definition is a drop of > 20 mm Hg systolic, 10 mm Hg diastolic, or both. Symptoms of faintness, light-headedness, dizziness, confusion, or blurred vision occur within seconds to a few minutes of standing and resolve rapidly on lying down. Some patients experience falls, syncope (see Syncope), or even generalized seizures. Exercise or a heavy meal may exacerbate symptoms. Most other associated symptoms and signs relate to the cause. Orthostatic hypotension is a manifestation of abnormal BP regulation due to various conditions, not a specific disorder.
SOOOOO... if a patient is hypotensive when the enter the care arena while in a recumbent position, it isn't surprising it drops more with a change of position.
Frequently orthostatic hypotension is documented only. As it is a stand alone diagnosis, it seems that BOTH hypotension AND orthostatic hypotension could be coded, and selection of principal could be either. ( I agree querying for dehydration may also be appropriate and may direct the PDX, but I am merely trying to see if anyone has had discussion on the subject of coding both orthostatic hypotension AND hypotenstion).
My current situation is one that the pt just discharged day before for admit for same reason. the bp was 90 lying dropped to 80. which technically isn't a drop of 20mm HG AND they were dizzy lying as well it just got worse..... AND they are an ESRD pt (which is what I am trying help be captured).
I was thinking of querying...
-Dehydration causing hypotension AND orthostatic hypotension
-Hypotension AND orthostatic hypotension, cause unknown
-Orthostatic hypotension only, BP low ONLY with position change. Not hypotensive otherwise/ orthostatic hypotension only
- other
-unable to determine
Thanks for your thoughts!