vasoplegia

mulled2mulled2
in CDI Talk Archive
Hi all,
We have been getting vasoplegia as an answer to cardiogenic shock queries (post open heart surgery). Meaning no CV shock but hypotension d/t vasoplegia. Vasoplegia is not a codable term but does carry a 25% mortality rate.
Upon further research it appears this is a form of vasodilatory shock which codes out to other shock (an mcc) Are any other people having this issue and what are you doing?
Thanks
Deb
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Comments

  • cynthia.hudson@christushealth.orgcynthia.hudson@christushealth.org
    edited March 2016
    Yes, just starting seeing Vasoplegia. I queried for shock with clinical indicators for shock and use of IntraAortic Balloon Pump.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
    [CCDS_pin_1inch]
    "We are His hands". Isaiah 64:8

  • annnd2009@gmail.comannnd2009@gmail.com
    edited March 2016
    Why not query vasodilatory shock
    Cardiogenic shock
    Other
    Unable to determine?

  • dsmith12h@aol.comdsmith12h@aol.com
    edited March 2016
    I have seen vasoplegia documented on CPB patients in the past. I had a one on one with the CVTS surgeon and was told it was a form of vasodilatory shock. He explained that cardiogenic shock is a "pump" problem and vasodilatory shock/vasoplegia is a"tube" problem. The outcome of the discussion resulted in documentation of "vasodilatory shock". It was coded as "other shock" because the was not a specific code for "vasodilatory shock".

    Debbi Smith RN, CCDS, CCS

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited March 2016
    Also ‘sounds like’ failure of peripheral circulation, which also codes to ‘shock’.



    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

  • cynthia.hudson@christushealth.orgcynthia.hudson@christushealth.org
    edited March 2016
    The cases I am referring to are emergency cases, STEMI, signs and symptoms of cardiogenic shock that required intra-aortic balloon pump. Sometimes the IABP has been used just to improve cardiac output for EF 20% with multiple blockages. This would never be used as a query for shock. Post cardiac surgery we usually see some of those patients on pressors but this resolves quickly and does not fit the picture of shock.

    Syndi Hudson, RN, CCDS,CCM
    CHRISTUS Santa Rosa New Braunfels
    CDI Specialist
    cynthia.hudson@christushealth.org
    830-643-6116 (Office)
    830-643-5139 (Fax)
     
  • Unknown
    edited March 2016
    Looks like you've got it totally. Way to go!

    Robert S. Gold, MD
    CEO DCBA,Inc
    4611 Brierwood Place
    Atlanta, GA 30360

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