| Course | HI253 Medical Coding I |
|---|---|
| Unit | Unit 5 |
| Paper type | Chapter specific problem set |
| Length | About 870 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health Information Management |
| Updated | October 2026 |
Free sample paper for HI253 Unit 5
When the Classification Presumes the Link: A Unit 5 Chapter Specific Problem Set Coding Six Composite Hypertension Cases From an Uncomplicated Diagnosis to Heart and Kidney Disease Together, Secondary Hypertension and a Reading That Is Not a Diagnosis
[Student Name]
Purdue University Global
HI253: Medical Coding I
Unit 5 Chapter Specific Problem Set
[Instructor Name]
[Date]
The problems are composite; the code entries, guideline rules and sources cited are real and follow the FY 2026 ICD-10-CM.
The Rule That Shapes Every Answer
In most chapters a coder links two conditions only when the provider documents the link or the index builds it in. The hypertension guideline reverses that default. Hypertension with heart involvement and hypertension with chronic kidney disease are presumed to be causally related, so the combination categories apply even when the provider simply lists both conditions, unless the documentation clearly states that the condition has another cause (National Center for Health Statistics, 2025). Each problem below applies that presumption or shows where it stops.
Problem 1
Stem: A composite 55-year-old is seen for a blood pressure check. The physician documents essential hypertension, well controlled on lisinopril. No heart or kidney disease is recorded. Answer: I10, essential (primary) hypertension. The code needs no further characters, and the term essential is a nonessential modifier in the index, so hypertension documented without it leads to the same code.
Problem 2
Stem: A composite 68-year-old with long-standing hypertension is admitted with worsening shortness of breath. The physician documents chronic diastolic heart failure and hypertension. Answer: I11.0, the hypertensive heart disease code for patients whose heart has failed, followed by I50.32, chronic diastolic heart failure, as the use additional code note at I11.0 directs. The physician did not write that the hypertension caused the heart failure; the guideline presumes it. Had the physician attributed the heart failure to another condition, such as a valve disease, the presumption would not apply, and I10 and the heart failure code would be reported separately as documented. The physician wrote two diagnoses side by side. The chapter guideline, not the physician, supplies the word because.
Problem 3
Stem: A composite 72-year-old with hypertension and chronic kidney disease, stage 4, is seen by nephrology. No heart disease is documented. Answer: I12.9, the hypertensive kidney disease code used when the kidney disease is below stage 5 or its stage is not given, followed by N18.4 for the stage. Reporting I10 and N18.4 as two unrelated codes is the most common wrong answer to this problem, because it ignores the presumption. The category changes at the far end of the scale: had the nephrologist documented stage 5 disease or end-stage renal disease, the answer would move to I12.0 with N18.5 or N18.6, and a patient on dialysis would also need Z99.2 for that status.
Problem 4
Stem: A composite 79-year-old with hypertension comes into the hospital short of breath, and the attending records an acute flare of chronic systolic heart failure. The record also documents chronic kidney disease, stage 3a. Answer: I13.0, the code for hypertension affecting both heart and kidneys when the heart has failed and the kidney disease sits below stage 5, followed by I50.23 for the type of heart failure and N18.31 for the stage. The single I13 category exists for patients with both heart and kidney involvement, so neither I11.0 nor I12.9 is used. Because the patient was admitted for the heart failure, I13.0 is sequenced first, as the chapter guideline directs for the combination categories, and the two additional codes follow it.
Problem 5
Stem: A composite 46-year-old is found to have hypertension caused by atherosclerotic stenosis of the right renal artery, confirmed on imaging. The visit is to manage the blood pressure. Answer: I15.0, renovascular hypertension, and I70.1, atherosclerosis of renal artery. Secondary hypertension always takes two codes, one for the hypertension and one for its underlying cause, and the reason for the encounter decides which comes first. Because this visit was for the blood pressure, I15.0 leads.
Problem 6
Stem: A composite 38-year-old's blood pressure at an annual physical reads 148/94. The physician notes elevated blood pressure, plans a repeat reading in four weeks and does not diagnose hypertension. Answer: R03.0, the code for a high reading that has not been diagnosed as hypertension. The hypertension categories are not used. A single high reading in a clinic is not a diagnosis, and current guidance on blood pressure measurement stresses that readings must be repeated and confirmed, often outside the office, before hypertension is diagnosed (Muntner et al., 2019). The code follows the physician's restraint.
What the Set Shows
Five of the six problems turn on the same guideline paragraph, applied or withheld. The presumption pulls two listed conditions into a combination category, the provider's attribution of another cause pushes them apart, and the absence of a diagnosis keeps a reading out of the chapter altogether. Errors on these problems are usually not lookup errors but rule errors, which is why accuracy studies treat a code that is valid but wrong for the record as a distinct kind of mistake (O'Malley et al., 2005). A coder who knows only the index would answer Problems 2, 3 and 4 incorrectly every time.
References
Muntner, P., Shimbo, D., Carey, R. M., Charleston, J. B., Gaillard, T., Misra, S., Myers, M. G., Ogedegbe, G., Schwartz, J. E., Townsend, R. R., Urbina, E. M., Viera, A. J., White, W. B., & Wright, J. T., Jr. (2019). Measurement of blood pressure in humans: A scientific statement from the American Heart Association. Hypertension, 73(5), e35-e66. https://doi.org/10.1161/HYP.0000000000000087
National Center for Health Statistics. (2025). ICD-10-CM official guidelines for coding and reporting FY 2026. Centers for Disease Control and Prevention.
O'Malley, K. J., Cook, K. F., Price, M. D., Wildes, K. R., Hurdle, J. F., & Ashton, C. M. (2005). Measuring diagnoses: ICD code accuracy. Health Services Research, 40(5p2), 1620-1639. https://doi.org/10.1111/j.1475-6773.2005.00444.x
The Purdue Global HI253 Unit 5 instructions
Chapter specific units usually take one body system and ask you to apply the extra rules its guideline adds. In this unit the prompt commonly supplies five to eight short cases built around hypertension, heart disease and chronic kidney disease, though some sections choose diabetes or pregnancy instead. You are expected to find the combination category, add the codes the tabular notes call for, such as the type of heart failure or the stage of kidney disease, and sequence them correctly. At least one case typically tests whether you recognize the presumption, and another tests whether you can tell a documented diagnosis from a single high reading. A brief justification under each answer is normally required, along with an APA reference to the current guidelines and the edition of the code set.
Inside the HI253 Unit 5 example
The set opens with the rule that shapes every answer, the presumed link between hypertension and heart or kidney involvement, and states the one exception. Problem 1 codes uncomplicated hypertension alone. Problem 2 links heart failure to hypertension with a highlighted line explaining that the guideline, not the physician, supplies the word because. Problem 3 adds a kidney disease stage. Problem 4 combines heart and kidney disease in a single category with its additional codes in the order the notes require. Problem 5 codes secondary hypertension with its cause. Problem 6 shows an elevated reading coded as a finding. Each problem sets out the documentation, the codes in sequence and the guideline line used. A closing section draws the six outcomes into one comparison.
Reading the HI253 Unit 5 grading rubric
Points in chapter units fall mainly on correct codes and correct order, with additional credit for each additional code a tabular note requires. Instructors frequently weight the presumption problem heavily, because a student who codes hypertension and heart failure separately misses the central rule of the chapter. Sequencing of combination codes before their companion codes is a separate item in many rubrics. Explanations that quote or cite the chapter guideline earn their own share. The elevated reading problem is often worth more than it looks, since coding it as hypertension shows a misunderstanding of documentation. Smaller amounts go to presentation and to a correct APA reference. Answers without guideline support may get the code right and still lose up to a third of the points.
HI253 Unit 5 help from the desk
The mistake that costs most here is coding hypertension and heart disease as two independent conditions when the guideline presumes a link. Close behind is forgetting the extra code for the type of heart failure or the stage of kidney disease. Some students reverse the order, putting the heart failure code ahead of the combination category. Others treat a single high blood pressure reading as hypertension, though no provider diagnosed it. Secondary hypertension is also miscoded when the underlying cause is left out. We can solve the chapter problems your section assigned, whether they cover hypertension, diabetes or another system, with the guideline line behind every answer. Send the cases, the edition and your format, and note any problems your instructor flagged in class.
Get an HI253 Unit 5 example written to your instructions
Which chapter did your section assign for Unit 5, circulatory, endocrine, obstetric or another? Send that problem set with its instructions and rubric, and the answers are worked in the order shown here: index path, quoted note, cited chapter guideline, code sequence. Delivery takes 24-48h, and no fee applies to the first custom sample. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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HI253 Unit 5 questions, answered
Why is hypertension such a common choice for this unit?
Because its chapter guideline overrides a habit most learners bring from other chapters, the expectation that a cause must be documented before two conditions are linked. The presumption of a causal relationship is easy to state and easy to miss in practice. Other sections choose diabetes, pregnancy, injuries or infectious disease for the same reason: each chapter changes a general rule.
What if the physician says the heart failure has a different cause?
Then the presumption does not apply. Where the documentation specifically attributes the heart failure to another condition, the hypertension and the heart failure are coded separately, each as documented. The sample includes a sentence on this in problem two so the presumption is not read as absolute. A query is appropriate where the record is unclear about the cause.
Does the sample show hypertensive urgency or crisis?
Not in the six problems shown, though many sections add one. The classification has entries for hypertensive urgency, emergency and crisis, and the guideline adds that any identified hypertensive disease is coded alongside them. A sample written to a set that includes such a problem would show that pairing and cite the paragraph behind it.
Where can I find a free HI253 Unit 5 sample paper?
This page holds a complete Unit 5 chapter specific problem set with six hypertension problems, from I10 alone to I13.0 with its additional codes, secondary hypertension and an elevated reading.
Is a single high blood pressure reading coded as hypertension?
No. Without a provider diagnosis of hypertension, an elevated reading is coded as a finding, R03.0, which is how the sample treats it in the final problem.