FW: CHF question

dvitalone1

OK, since this CDI talk evolved our coders are in a state of confusion. First they did not know that they can code ACUTE when decompensated is written with CHF. Second….they want to know if this applies to any disease process when decompensated is written…for example decompensated cor pulomale




Subject: FW: [cdi_talk] CHF question


Exacerbation of diastolic congestive heart failure
Coding Clinic, Third Quarter 2008 Page: 12 Effective with discharges: September 19, 2008


Question:

When a patient with a known history of CHF is admitted with an exacerbation of diastolic congestive heart failure, how would this be coded?

Answer:

Assign code 428.33, Diastolic heart failure, acute on chronic, and code 428.0, Congestive heart failure, unspecified. Dorland's Medical Dictionary defines "exacerbation" as an increase in the severity of disease or any of its symptoms. The terms "exacerbated," and "decompensated" indicate that there has been a flare-up (acute phase) of a chronic condition.

catladyrn

Wow, I never knew that, either. I've never assumed decompensated could be coded as acute, and AFAIK, neither have any coders I know. I've always queried. In fact, I queried a cardiologist the other day to ask if decompensated HF was acute and he wrote back that it was chronic.

Renee


Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center

judithbates

If I'm not mistaken, this is not the first time this question has been discussed on CDI talk. Decompensated is synonymous with acute when it comes to CHF... Does anyone know about other disease processes? COPD?

Unknown

Yes, I just posted the Coding Clinic for Decompensated COPD.

~Norma

dvitalone1

Where did you pst the coding clinic?


Dawn M. Vitalone, RN
Clinical Documentation Improvement Specialist
Community Hospital
Munster, IN
219-513-2611