What is the PDX: OHS/OSA vs Acute resp failure vs hypertension heart failure
Patient Admitted for AHRF and Acute HFpEF exacerbation, hypertension, thought to be secondary to untreated OHS/OSA. Improvement in respiratory status following diuresis and initiation of BiPAP.
Our cardio providers believe the underlying etiology of their
heart failure is due to their poorly tx OHS/OSA and believe the PDX should not
go to the heart failure or resp failure code but possible the OHS/OSA.
What are your thoughts on the PDX on this case? Let me know if
you need additional information.
Thanks Kim
Comments
Hi Kim,
There are some conditions which have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For conditions, the ICD-10-CM has a coding convention where the underlying condition be sequenced first, if applicable, followed by the manifestation. Wherever this combination exists, there's a use additional code note at the etiology code, and a code first note at the manifestation code. These instructional notes show the proper sequencing order of the codes, etiology followed by manifestation. None of the diagnoses in this scenario have those instructional notes.
Some things to consider when selecting the PDx:
Which condition bought the bed? If there are two or more conditions that are equally treated and POA, either could be the PDX.
Which are acute conditions? (Chronic conditions are vulnerable to audit)
Could any of these conditions be treated without an inpatient admission?
Hope this helps,
Kelly Sutton