Cardiac arrest
Can anyone help me with this case? Synopsis follows:
84 year old female presented with recurrence of colon cancer. Bowel
resection performed. Suffered cardiac arrest on HD 7. Asystolic when
found. Code 99 unable to resuscitate. Cardiac arrest was not coded.
Patient was expected to recover and was never placed on palliative
care/comfort measures only.
My coding manager maintains that the cardiac arrest is not coded and
cites this reference:
Cardiac arrest documented as cause of death. Coding clinic referenced
from 1995 states, "When cardiac arrest occurs during the course of
hospitalization and the patient is resuscitated, code 427.5 may be used
as a secondary code except as outlined in the exclusion note under
category 427."
"However, when the physician records cardiac arrest to indicate an
inpatient death, do not assign code 427.5 when the underlying cause or
contributing cause of death is known since the Uniform Hospital
Discharge Data Set (UHDDS) has a separate item for reporting deaths
occurring during an inpatient stay."
This just does not seem at all logical. I can understand not coding
cardiac arrest when the patient is CMO, but an unexpected cardiac
arrest?
Cathy L. Seluke, RN, BSN, ACM, CCDS
Supervisor Clinical Documentation Compliance
MaineGeneral Medical Center
Augusta and Waterville, Maine
P. 207.872.1796
F. 207.872.1594
Cathy.Seluke@mainegeneral.org
84 year old female presented with recurrence of colon cancer. Bowel
resection performed. Suffered cardiac arrest on HD 7. Asystolic when
found. Code 99 unable to resuscitate. Cardiac arrest was not coded.
Patient was expected to recover and was never placed on palliative
care/comfort measures only.
My coding manager maintains that the cardiac arrest is not coded and
cites this reference:
Cardiac arrest documented as cause of death. Coding clinic referenced
from 1995 states, "When cardiac arrest occurs during the course of
hospitalization and the patient is resuscitated, code 427.5 may be used
as a secondary code except as outlined in the exclusion note under
category 427."
"However, when the physician records cardiac arrest to indicate an
inpatient death, do not assign code 427.5 when the underlying cause or
contributing cause of death is known since the Uniform Hospital
Discharge Data Set (UHDDS) has a separate item for reporting deaths
occurring during an inpatient stay."
This just does not seem at all logical. I can understand not coding
cardiac arrest when the patient is CMO, but an unexpected cardiac
arrest?
Cathy L. Seluke, RN, BSN, ACM, CCDS
Supervisor Clinical Documentation Compliance
MaineGeneral Medical Center
Augusta and Waterville, Maine
P. 207.872.1796
F. 207.872.1594
Cathy.Seluke@mainegeneral.org