Assessment of LV and RV function

ValskennedyValskennedy
in CDI Talk Archive
Do the codes 428.2X and 428.3X Systolic and Diastolic heart failure pertain to left ventricular function only? Is it assessment of left ventricular function rather than right that leads to the specificity of systolic vs diastolic?

Comments

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    My basic understanding is, yes. I could be way off on this but I have been told that systolic/diastolic pertains to L-sided heart failure only and that that if a provider is saying R-sided heart failure it would be inappropriate to ask for further specificity of systolic/diastolic.
    This would only be true in the instance that the R-sided failure is not caused by L-sided failure. If that was the case obviously you could further specify systolic/diastolic on the L-sided failure.

    I am hoping someone else can confirm my understanding or set me straight :-)

    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
  • Unknown
    edited April 2016
    You are correct, Katy. If it's right heart failure only, there is no code for diastolic or systolic. This is actually an area where Dr. Gold has tried getting new codes assigned, with no success so far.
    Linda Haynes
    Legacy Health
    lhaynes@lhs.org

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    Whooohooo!! I was RIGHT!!

    I needed that :)

    R-sided heart failure is a huge frustration of mine when it comes to coding. Glad it's not just me.

    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
  • jschoonhovenjschoonhoven
    edited April 2016
    Cor Pulmonale sometimes is the way to capture this. If the Right HF is driven by a restrictive pulmonary process, it captures that clinical scenario.
    Takes a lot of teaching and support with physicians to take on that wording, but that's what we are here for!
    I don't entirely agree though that right HF cannot be expressed in terms of systolic / diastolic. If the EF is low, there is an issue here.
    Janice

    Janice Schoonhoven RN, MSN, CCDS
    Clinical Documentation Integrity
    Manager- PeaceHealth Oregon West Network
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    I agree, we have a query like this....

    The medical record indicates a diagnosis of HEART FAILURE. The patient has the also has a history of (Possible underlying pulmonary process: COPD, ILD, CF, Pulm HTN). During this admission, the patient has had the following symptoms/treatment.
    _____Edema/Ascites
    _____Jugular Vein Distention
    _____Diuretics
    _____Antihypertensives
    _____Other: (EX: 02, dobutamine, salt restriction)

    Please provide further specificity to the diagnosis of HEART FAILURE, if possible:
    Right-Sided Heart Failure secondary to Left-Sided Heart Failure (CHF). (Please also document if systolic/diastolic/combined and whether acute/chronic/acute on chronic).
    Cor Pulmonale: Right-sided heart failure originating in the pulmonary circulation system.
    Acute Cor Pulmonale or Chronic Cor Pulmonale
    Left-Sided Heart Failure (CHF) WITHOUT Right-Sided Failure. (Please also document if systolic/diastolic/combined and whether acute/chronic/acute on chronic).
    Other:
    None of the above

    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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