hypertension and CHF
A pt is admitted with acute CHF (no h/o of CHF is noted) with BP's running 209-228 systolic and 77-89 diastolic for first 7 hours at admit. BP was elevated at care center per family. CV and renal have been consulted and BP meds have been adjusted. Would this be an appropriate time to ask if CHF is due to HTN?
Thanks,
Tara
Thanks,
Tara
Comments
Thanks.
I speak to our cardiologist on these types of cases when not linked. With the clinical picture, results and the medications used for treatment, you then maybe can get them to place the linkage if appropriate.
Tiffany Andras LPN
Thibodaux Regional Medical Center
Clinical Documentation Nurse
985-493-4593
Thibodaux Regional Medical Center
Clinical Documentation Nurse
985-493-4593
I have not queried in for a linkage of CHF and HTN before so I just wanted to make sure it was appropriate in this instance. (trying to step out of my box of the routine CHF type, CKD stage queries,etc.)
Thank you!
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
If the heart failure (or other heart disease) is due to
hypertension
If the current overall cardiac picture represents hypertensive
heart disease
No link between heart failure (or other heart disease) and
hypertension
Other (please document)
Unable to determine
Please remember to ask for the CHF type always.
Another point: if CKD is documented (and do not need link to either HF
or HTN) as well as hypertensive heart disease from your query response,
it will bring you to the 404.xx codes (Hypertensive heart and chronic
kidney disease). This then becomes principal diagnosis within CHF DRG's
(291-293). Then the acute (type) CHF is allowed as MCC within its own
CHF DRG's. Doesn't make sense but see ICD-9 code book for code 404.xx
that shows the CHF specificity is coded as an additional code after the
404.xx code. Let's enjoy while we can until the powers that be discover
this and take it away.
Karen Maritano, R. N.
Clinical Documentation Specialist
Legacy Health
Portland, Oregon
503-413-7154
systolic or combined.