RE: [EXTERNAL] RE: end stage CHF
Typically yes, but there are many different causes of both diastolic and systolic heart failure with varying signs and symptoms based cause. All of these factors are used in determining type and/or stage of heart failure. If the MD states that the patient has heart failure and the patient is being treated for chronic or acute on chronic heart failure, then one would assume that the patient has a history of myocardial dysfunction. The MD should be able to specify the type of heart failure based on clinical presentation and the patient’s contributing history. In patients with documented heart failure, at minimum, they all have some extent of diastolic dysfunction. Anyone with systolic heart failure has diastolic dysfunction in addition to systolic dysfunction, but not everyone who has diastolic heart failure has systolic dysfunction.
It appears that my experience with Cardiology has been different from yours. The criteria that we use today to determine whether to query for heart failure, type of heart failure and/or acuity of heart failure is based on evidence based medicine publications, our internal physician’s understanding of this information and extensive discussions with the Cardiology team at Cleveland Clinic and various heart failure clinics at large academic facilities.
I am not surprised to hear that there is a difference of opinion within your medical staff. Further discussions with your medical staff and education regarding capturing of heart failure specificity based on the current coding system may help. This type of conversation may be more beneficial coming from a physician (preferably a Cardiologist) that has extensive clinical, coding and documentation knowledge?
Wendy Clesi, RN, CCDS
Director CDI Services
Huff DRG Review
985-778-8489
Wendy.clesi@drgreview.com
It appears that my experience with Cardiology has been different from yours. The criteria that we use today to determine whether to query for heart failure, type of heart failure and/or acuity of heart failure is based on evidence based medicine publications, our internal physician’s understanding of this information and extensive discussions with the Cardiology team at Cleveland Clinic and various heart failure clinics at large academic facilities.
I am not surprised to hear that there is a difference of opinion within your medical staff. Further discussions with your medical staff and education regarding capturing of heart failure specificity based on the current coding system may help. This type of conversation may be more beneficial coming from a physician (preferably a Cardiologist) that has extensive clinical, coding and documentation knowledge?
Wendy Clesi, RN, CCDS
Director CDI Services
Huff DRG Review
985-778-8489
Wendy.clesi@drgreview.com