Endocarditis

ksammonsksammons
in Clinical & Coding
Need the opinion of the group regarding coding Endocarditis once infected native valve removed but still under treatment with post-op antibiotics for 6wks.  Patient was re-admitted 5 days prior to completing the IV antibiotics.  Coder does not feel we can still code the endocarditis since the infected native valve was removed  on a prior admit (pt was septic with Endocarditis on previous admit and ended up having a MVR).  Thoughts?

Comments

  • ksammonsksammons
    edited October 2018
    ksammons said:
    Need the opinion of the group regarding coding Endocarditis once infected native valve removed but still under treatment with post-op antibiotics for 6wks.  Patient was re-admitted 5 days prior to completing the IV antibiotics.  Coder does not feel we can still code the endocarditis since the infected native valve was removed  on a prior admit (pt was septic with Endocarditis on previous admit and ended up having a MVR).  Thoughts?


    Still waiting for any opinions/thoughts from coding professionals out there.  Thanks!


    Kate Sammons, BS, RN, ACM, CCDS

  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    Why was the patient admitted 5 days prior to the completion of IV antibiotics? What was the focus of care during the hospital stay?

    Jeff

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org

    I'd not advocate it is permitted to code this as an active problem.  The infected site has been resected and replaced.

    Paul

  • ekilbo@ghs.orgekilbo@ghs.org

    This is a tough one.  The only similar scenario I can think of is where a neoplasm is excised completely and the patient is still undergoing treatment.  ICD-10-CM guidelines (1-C-2-M) notes "When a primary malignancy has been excised but further treatment, such as ....... the primary malignancy code should be used until treatment is completed".  Using that logic you could probably make the argument it was OK to add the code. 

    Personally I have to agree with Paul I don't believe it is appropriate to code it in this scenario.  This would be a good scenario to send to AHA Coding Clinic. 

    Erik Kilbo, CCDS, CDIP, CCS, CPC-I
    Manager - Enterprise HIM Coding
    Greenville Health System

  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu
    ekilbo@ghs.org said:

    This is a tough one.  The only similar scenario I can think of is where a neoplasm is excised completely and the patient is still undergoing treatment.  ICD-10-CM guidelines (1-C-2-M) notes "When a primary malignancy has been excised but further treatment, such as ....... the primary malignancy code should be used until treatment is completed".  Using that logic you could probably make the argument it was OK to add the code. 

    Personally I have to agree with Paul I don't believe it is appropriate to code it in this scenario.  This would be a good scenario to send to AHA Coding Clinic. 

    Erik Kilbo, CCDS, CDIP, CCS, CPC-I
    Manager - Enterprise HIM Coding
    Greenville Health System


    Agree with you both...I'm curious to know why the patient was admitted and were they just completing antibiotics as a course of treatment. Definitely would be a good scenario for coding clinic to answer.
  • ksammonsksammons

    Thanks everyone for your comments.  The patient was readmitted with a non-traumatic Hemorrhagic CVA.  She was a complex case.  The patient was septic with the endocarditis on the previous admit hence is why I thought you could still code the endocarditis since she was still under treatment and at risk (since septic). 

    Kate Sammons, BS, RN, ACM, CCDS

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