CHF again

laura.bohls@prairielakes.com

Just when I thought the doctors had CHF down, they've thrown me another curve ball. Two of my hospitalists have started documenting "vavular CHF", when we ask them if they are able to determine systolic or diastolic they reply to me "neither, it's vavular." Does anyone have any words of wisdom or references regarding this?
Thanks,
Laura Bohls, RN CDS
Prairie Lakes Hospital
Watertown, SD 57201

mark.dominesey

One of my co-workers told that there was a presentation at AHIMA last week that covered this same thing. Apparently physicians are now unable/unwilling to say that the resulting CHF caused by the valvular problem is either systolic or diastolic. This physician said that the unspecified CHF code was the one to use in this instance.

I believe this to be controversial and it should be submitted to coding clinic for both ICD-9 and ICD-10.

Kindest Regards,

Mark

Mark Dominesey

belnapc

I have no words of wisdom, but our Cardiologists feel the same. We have just continued to let them know that sometimes the coding world and the clinical world do not match, and this is one of those instances and then we show them the only options the coders have for assigning codes for CHF. Sometimes it works, even though deep down the Cardiologists don't like it.

Cara Belnap MS, RN, CCDS                                                       
Lead Clinical Documentation Specialist | Health Information Management
St. Luke's Health System | 190 E Bannock St. | Boise, ID 83712
Phone: (208)  381-9302| Fax: 208-381-7186 | E-mail: belnapc@slhs.org

laura.bohls@prairielakes.com

I see this was discussed a couple of months ago. Sorry I didn't look in the archives before I posted. I'm going to listen to ACDIS radio archives when I get a minute this afternoon, but I'd still appreciate any additional insight if anyone has any

Laura Bohls, RN
Clinical Documentation Specialist
605-882-5454