Auto Link for CHF and Hypertension
How are you handling the automatic link, especially when the patient also has atrial fibrillation or myocardial ischemia? Do you have guidelines on when to Query?
Tagged:
Comments
Atrial fib and Myocardial ischemia do not fall into that category.
I10 CM Official Guidelines for Coding and Reporting
C. Chapter Specific Coding Guidelines
9. Chapter 9: Diseases of Circulatory System (I00-I99)
a. Hypertension
1) Hypertension with Heart Disease
Hypertension with heart conditions classified to I50.- or I51.4-I51.9, are assigned to a code from category I11, Hypertensive heart disease. Use an additional code from category I50, Heart failure, to identify the type of heart failure in those patients with heart failure. The same heart conditions (I50.-, I51.4-I51.9) with hypertension are coded separately if the provider has specifically documented a different cause. Sequence according to the circumstances of the admission/encounter.
Hello,
I have a similar question. I have a patient with longstanding HTN and CHF. I understand the automatic link but the attending is also documenting HF d/t stenosis of a valve. Does the documentation of HF d/t stenosis of a valve automatically 'unlink' the Hypertension with Heart Disease link? The provider has NOT stated the HF is unrelated to the HTN.
Would a query for multifactorial causes of HF be appropriate or needed?
I have attached a recent coding clinic that I am using as a reference
Hypertension with congestive heart failure
ICD-10-CM/PCS Coding Clinic, First Quarter ICD-10 2017 Page: 47 Effective with discharges: March 13, 2017
Question:
In the guideline for hypertension with heart disease, category I50, Heart failure, is included in the list of heart conditions that are classified as hypertensive heart disease, but it is not included in the Alphabetic Index nor Tabular List. Is congestive heart failure (CHF) in a patient with hypertension coded as hypertensive heart disease with failure, when the provider's documentation has not explicitly linked the two conditions?
Answer:
Assign code I11.0, Hypertensive heart disease, with failure, along with the appropriate code from category I50, Heart failure, for CHF in a patient with hypertension. The classification presumes a causal relationship between hypertension and heart involvement unless the provider documents that the conditions are unrelated.
Although heart failure is not in the list of heart conditions in the inclusion note, in ICD-10-CM, there is a note instructing "Use additional code to identify type of heart failure" in the Tabular List. The code range under category I11, Hypertensive heart failure, is not intended to be an all-inclusive list. The range of heart conditions in the Alphabetic Index and Tabular List will be considered for future modification through the Coordination and Maintenance Committee
© Copyright 1984-2017, American Hospital Association ("AHA"), Chicago, Illinois. Reproduced with permission. No portion of this publication may be copied without the express, written consent of AHA.
Thank you in advance,
Patty
Patricia Matson Vitasinski RN CCDS
Manager, Clinical Documentation Improvement
Henry Ford Health System
(313) 916-2793
(248) 961-2178 cell
email- pvitasi2@hfhs.org