valvular chf

kerryseekircherkerryseekircher
edited April 2016 in CDI Talk Archive
When the EF is normal and the CHF type is queried, I sometimes get a response of "valvular".
In these cases, the MD will state that diastolic is not appropriate either; usually in cases with severe AS or mitral regurgitation.
On the other hand, I have had cardiologists tell me if it is not systolic, it is by default diastolic.
Which one is correct? : )
Thanks,
Kerry

Kerry Seekircher, RN, BSN, CCDS, CDIP
Documentation Specialist Supervisor
Northern Westchester Hospital
400 East Main Street
Mount Kisco, NY 10549
Email: kseekircher@nwhc.net
Phone: 914-666-1243
Fax: 914-666-1013




Comments

  • martin.conroymartin.conroy
    edited April 2016
    This is a job for a physician champion preferably in Cardiology leadership. Ask if it can be addressed in a staff meeting. Avoid using words like "correct" unless you are a physician. Emphasize the need for consistent documentation from the team. If they are unaware of the significance of systolic & diastolic you want to address in the setting of group education. I would include a slide with similar terms we can't specifically code:

    * acute exc. of chf

    * End stage heart disease

    * Acute BIV heart failure

    * Chf normal ejection fraction

    * Severe heart failure

    * Acute R HF

    Use their words and explain they do not impact SOI, ROM, report cards, rankings, & oh yeah $$$$$$$

    Let the physicians reach consensus and support your need to seek more specific documentation.

    If you brief a champion ahead of time she/he can drive the conversation and you are not the one "correcting" a physician.

    Just my thoughts on a Friday......

    Marty
    Temple Health

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    I find inconsistency w/ our staff in regards to designating forms of CHF as Diastolic or Systolic when the etiology is valvular disease. Some readily classify such HF pts as systolic or diastolic, while others won't make that distinction.


    Marty's points are dead on, and if you are fortunate enough to have a physician champion in Cardiology for assistance, by all means utilize that asset.



    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

  • kerryseekircherkerryseekircher
    edited April 2016
    Thank you both for the good points and I'm sorry I missed that ACDIS call!
    It is not common that this occurs, but when it does I am stumped. I appreciate your feedback.
    Kerry

    Kerry Seekircher, RN, BSN, CCDS, CDIP
    Documentation Specialist Supervisor
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013



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