watershed
Can anyone provide some input on how you handle the cardiologist writing
"watershed effect" or "watershed event". My research has shown that
this can occur with afib, stroke and MI. One physician says it is a
subendo MI but another disagrees. I know it must be queried but wanted
to know if anyone had a good cardiology definition for this or if you
are seeing it.
Deanne Wilk, BSN, RN, CCS
AHIMA Approved ICD-10-CM/PCS Trainer
CDI Manager
Health Information Management Systems Department
Good Samaritan Health System
4th & Walnut Streets
Lebanon, PA 17042
717 270 4804
This Message is intended only for the use of the individual or entity to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination or copying of this message or the taking of any action in reliance on the contents of this message is strictly prohibited. If you have received this message in error, please notify us immediately and destroy the original message. Thank you.
"watershed effect" or "watershed event". My research has shown that
this can occur with afib, stroke and MI. One physician says it is a
subendo MI but another disagrees. I know it must be queried but wanted
to know if anyone had a good cardiology definition for this or if you
are seeing it.
Deanne Wilk, BSN, RN, CCS
AHIMA Approved ICD-10-CM/PCS Trainer
CDI Manager
Health Information Management Systems Department
Good Samaritan Health System
4th & Walnut Streets
Lebanon, PA 17042
717 270 4804
This Message is intended only for the use of the individual or entity to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination or copying of this message or the taking of any action in reliance on the contents of this message is strictly prohibited. If you have received this message in error, please notify us immediately and destroy the original message. Thank you.
Comments
Cerebral infarction with hemorrhage
Coding Clinic, Second Quarter 2013 Page: 10 Effective with discharges: July 8, 2013
Question:
The patient suffered a subacute ischemic right posterior parietal watershed infarct with small focus of subacute hemorrhage. How should this condition be coded?
Answer:
Assign codes 434.91, Occlusion of cerebral arteries, Cerebral artery occlusion, unspecified, with cerebral infarction, and 431, Intracerebral hemorrhage, for subacute ischemic right posterior parietal watershed infarct with small focus of subacute hemorrhage. In this instance, the patient had an ischemic stroke as well as hemorrhagic stroke. Both codes are required to fully describe the condition. As usual, newer advice supercedes that previously published in Coding Clinic. The current advice supercedes the advice published in Third Quarter 1997, page 11.
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
question is when they use this term we should be looking for either MI
or stroke correct?
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
Thank you
(Anecdotally, I have only seen the term 'watershed' used in reference to CVA).
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: 415.412.9421
evanspx@sutterhealth.org