Cardiac arrest hours after admission
Patient arrived in the ED @ approximately 23:00 with chief complaint of fall earlier in the day. Also complains of worsening dyspnea. CTOH is negative. Besides the fall, H&P identifies Hypoxic respiratory failure with worsening SOB / Possible CHF / AKI / etc.. Alert and oriented on admission. Admitted as an inpatient to a medical floor at ~03:30. Patient arrested at 05:45, resuscitated, transferred to ICU. Died a short time later. Death summary notes primary diagnosis as Cardiac Arrest.
Our coding team identified "Cardiac arrest, cause unspecified" as the primary diagnosis. They indicated that "after study" this was the diagnosis that was the cause for the patient to be admitted.
Given the fact that patient was alert and oriented at time of admission and didn't arrest until several hours later, should the cardiac arrest drive the diagnosis or would one of the other initial diagnosis from the H&P drive the diagnosis.
Thoughts and comments really appreciated!