Descriptions of CHF

Unknown
edited May 2016 in CDI Talk Archive
I have two individual cases of CHF that are described as decompensated Diastolic CHF. Would you code it as acute on chronic diastolic CHF or would you query for the exact wording of acute on chronic? To me exacerbation is descriptive enough but I am still learning how literal Coding as a science is for CMS.

Mary L. Snook RN-BC
Clinical Documentation Specialist
Medical Information Services


Fairfield Medical Center
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Comments

  • lara.faustinolara.faustino
    edited May 2016
    I would certainly query.

  • rmhosler1rmhosler1
    edited May 2016


    Decompensation in the grouper is not the same as exacerbation. It codes
    to diastolic heart failure, unspecified. I agree, you would need to
    query.




    Mary A Hosler MSN, RN
    Clinical Documentation Specialist
    Alumnus CCRN
    McLaren Bay Region
    1900 Columbus Ave.
    Bay City, Michigan 48708
    (989) 891-8072
    mary.hosler@mclaren.org




  • annnd2009@gmail.comannnd2009@gmail.com
    edited May 2016
    Per a consultant...that should be good enough. diastolic chf would be the chronic and decompensation would be an decline and therefore acute. We were told unnecessary to query.
  • cynthia.a.goeweycynthia.a.goewey
    edited May 2016
    Hi,
    There is a coding clinic specific to decompensated systolic heart failure...2013/2: Assign code 150.32, Acute on chronic systolic heart failure, for decompensated systolic heart failure. "decompensated" indicates that there has been a flare-up (acute phase) of a chronic condition.
    Cindy

  • jolene.filejolene.file
    edited May 2016
    Hi Mary!
     
    The C.Clinic- 3rd Qrtr. 2008 addresses Exacertation  of diastolic CHF.     The term of "exacerbated & decompensated " indicate that there has been a flare-up of a chronic disease.   A query is not needed

    Jolene File,RHIT,CCS,CPC-H,CCDS
    Documentation Improvement Specialist-Coder
    Hays Medical Center
    jolene.file@haysmed.com

    IMPORTANT: This communication contains information from Hays Medical Center which may be confidential and privileged.  If it appears that the communication was addressed or sent to you in error, you may not use or copy this communication or any information contained therein, and you may not disclose this communication or the information contained therein to anyone else.  In such circumstances, please notify me immediately by reply email or by telephone.  Thank you.

  • ddouthitddouthit
    edited May 2016
    Per 3 Q 2008 coding clinic, decompensated would be coded as acute on chronic.

    Exacerbation of diastolic congestive heart failure

    Coding Clinic, Third Quarter 2008 Page: 12 Effective with discharges: September 19, 2008

    When a patient with a known history of CHF is admitted with an exacerbation of diastolic congestive heart failure, how would this be coded?

    Assign code 428.33, Diastolic heart failure, acute on chronic, and code 428.0, Congestive heart failure, unspecified. Dorland's Medical Dictionary defines "exacerbation" as an increase in the sverity of disease or any of its symptoms. The terms "exacerbated," and "decompensated" indicate that there has been a flare-up (acute phase) of a chronic condition.




    Dorie Douthit RHIT,CCS
    ddouthit@stmarysathens.org

  • rmhosler1rmhosler1
    edited May 2016


    I agree exacerbation--no need to query. Decompensation a different story
    at our organization.



    Mary A Hosler MSN, RN
    Clinical Documentation Specialist
    Alumnus CCRN
    McLaren Bay Region
    1900 Columbus Ave.
    Bay City, Michigan 48708
    (989) 891-8072
    mary.hosler@mclaren.org




  • Unknown
    edited May 2016
    Thanks for your help.

    Mary L. Snook RN-BC
    Clinical Documentation Specialist
    Medical Information Services
  • Unknown
    edited May 2016
    Thank you for your quick response.

    Mary L. Snook RN-BC
    Clinical Documentation Specialist
    Medical Information Services
  • Unknown
    edited May 2016
    See the other replies to this question. Everyone had different ideas.

    Mary L. Snook RN-BC
    Clinical Documentation Specialist
    Medical Information Services
  • kmaritankmaritan
    edited May 2016
    Even with the coding clinics shared already?



  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    Exacerbation 'or' Decompensated coded as acute on chronic - clearly stated as per Official Reference (Coding Clinic) as per response from Dorie and Robert. No need to query in this context.

    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org
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