CHF and fluid overload in CABG/Valve patient

Good morning everyone:

I am looking for some assistance regarding coding of certain conditions in the post CABG/valve patient.

1. Do you have a time frame you consider treatment of fluid overload/CHF to be "normal" in this patient population is it more patient specific based on history etc.
1A. Do you use ever use the mcc of pulm edema not related to CHF?
2. How do you code atril fibrillation that occurs in the postoperative period in a patient who has not had a previous history of Afib?
3. What DRG code do you use for a patient who is admitted in CHF after dc from the above procedures? ie Functional disturbances after surg or CHF

Hope this is clear.

Thanks so much for your assistance.

Mary Hosler MSN, RN CCDS
rmhosler@charter.net

Comments

  • 1. I am not sure on this, I would confer with the physician.
    1A. yes, but not if the patient has CHF. Only in patients without CHF
    2. depends on documentation. Is the physician saying it is due to surgery? If the connection is made, code as complication (997.1 and 427.31), if unclear, query.
    3. See above. You need documentation that it is related to the procedure. Otherwise it is just CHF. Query.

    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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