New AHA/ACCF guidelines for Heart Failure

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
We have recently had MDs refuse to designate CHF as systolic/diastolic because of the new AHA/ACCF guidelines for HF. They are wanting to just state 'heart failure with reduced ejection fraction' for systolic CHF.

Have you had this issue and how are you dealing with it?

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

Comments

  • cmorellcmorell
    Hi Katy,

    We explain that we are currently using ICD-9-CM codes. The rest of the world has been using ICD-10-CM since 1999. New coding terminology is a long process because it has input from physician panels, the four cooperating parties etc. So, while the AHA and ACC may now be using newer terminology and even including NYHA Class information...these cannot be coded. Certainly the physician can document these newer terms,but if they wish the great care they render to be reflected in the medical record and positively impact their quality ratings they ALSO need to use the terminology that can be coded.
    Otherwise that patient with Pneumonia and a decreased ejection fraction will look like he stayed too long in the hospital and the physician may not be a "preferred provider" in the future.

    Charrington "Charlie" Morell
    HCA WFD CDI Mgr.
  • redjay2redjay2
    edited May 2016
    Our Cardiologists hardly ever give us either. They just write the ef%. Or I look up the echo and fill in the query information. The residents or Primary MD gives us the detail.
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    Thank you for your response. This is basically what I was thinking as well but my boss was not thrilled about it because he is concerned they will be resistant to using 'old' terminology. I wanted to make sure I was on track :)

    Thanks again!

    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
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    This has been true for us as well. The issue here is that this is not coming from our cardiologist, this is our hospitalists who we are depending on giving us the detail needed for coding. They actually we were queried for the specificity and chose the ‘other’ option and free-texted that according to the new guidelines the appropriate term was ‘heart failure with reduced EF’. While I realize this, we cannot lose all our CHF-associated CC/MCC’s so we really need them to provide the systolic/diastolic designation.

    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
  • gwojogwojo
    edited May 2016
    Well stated Charlie.
  • catladyrncatladyrn
    Hi Katy,

    One of our CDI specialists just ran into the same problem with a cardiologist. I do note that the new guidelines state that HF with reduced EF is also referred to as systolic HF, and HF with preserved EF is also referred to as diastolic HF, which gives us a foot in the door to asking the physicians to continue documenting systolic and diastolic until coding guidelines catch up. I suggested that she gently tell the cardiologist that while we don't ever want to discourage physicians from using current clinical terms, they need to know that, as it has been since October 2008, the diagnosis will be CHF, unspecified, unless they document acuity and specificity.

    I really, really like Charlie's response to you.

    Renee

    Linda Renee Brown, RN, CCDS, CCS, CDIP
    Clinical Documentation Improvement Educator
    Novant Health Clinical Improvement
  • Unknown
    edited May 2016
    Katy,
    Do you guys have a good site for the new guidelines? I would love to
    read up on them. Thanks Jamie

    Jamie Dugan RN
    Clincal Documentation Improvement Specialist
    3563 Philips Highway, Suite #106
    Jacksonville, Florida 32207
    Office: 904-204-4345
    Cellular- 904-237-7253
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    I have seen a couple articles on the issue that discuss pieces, but have not read the entire document. My understanding is that the complete guidelines is a 300pg document. I have not read it but we have a physician that is going to be going through it and making hospital-wide recommendations.

    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
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