FW: 6485343

Please help me understand. If a physician documents "Mild congestive heart failure contributing to symptomology as well related to diastolic dysfunction" how would you all code this? I am sorry I am beating a dead horse but I am getting a lot of hesitancy from our coders here related to this subject and the coding supervisor tells me to "put it on CDI talk and let's see what they say." There is documentation of CHF exac and diastolic dysfunction throughout record and pt was treated for the CHF but the term acute diastolic heart failure is never written all together in the same sentence . Thanks for your input


Here is my coder's reasoning: According to coding clinic "Exacerbation of Diastolic CHF" should be coded to 428.33 "Diastolic Heart Failure, acute on chronic" and code CHF 428.0.
There is no where in the progress notes that state the patient has "Acute Diastolic CHF". I found CHF exacerbation on page 20, 9 and 5; page 13 and page 1 ,CHF with diastolic dysfunction. Diastolic dysfunction with CHF whether compensated or decompensated codes to 428.0 CHF. Unless I have definitive information that "diastolic dysfunction" and "diastolic heart failure" are the same, I cannot code it to diastolic heart failure.

DAWN

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Comments

  • edited May 2016
    Per Coding Clinic, if you have mention of diastolic dysfunction and CHF you combine them --> diastolic CHF (chronic).
    If you also have mention of CHF exacerbation you then get acute on chronic diastolic CHF.

    Charlene


  • edited May 2016
    I do not have access to any coding clinics. Would it be possible for you to forward me the clinic? Thanks so much!


    Dawn



  • edited May 2016
    CHF due to diastolic dysfunction is linking the two. so it is acceptable.

    Coding Clinic 4Q 2002
    Question:

    Coding Clinic, First Quarter 1993, pages 19-20, advised us to code a
    diagnosis of congestive heart failure due to diastolic dysfunction due to
    hypertension with code 402.91, Hypertensive heart disease, unspecified
    with congestive heart failure. Now that the heart failure codes have been
    revised effective October 1, 2002, how would this condition be coded with
    the new codes?

    Answer:

    You will now need three codes to completely describe this diagnosis.
    Assign codes 402.91, Hypertensive heart disease, unspecified with heart
    failure; 428.30, Diastolic heart failure, unspecified; and 428.0,
    Congestive heart failure, unspecified. The two additional codes provide
    the specificity required to report that the heart failure was diastolic
    type and congestive.

    Stacy Vaughn, RHIT, CCS, CCDS
    Data Support Specialist/DRG Assurance
    Aurora Baycare Medical Center
    2845 Greenbrier Rd
    Green Bay, WI 54311
    Phone: (920) 288-8655
    Fax: (920) 288-3052




  • edited May 2016
    Here you go. This is one of latest.



    Systolic dysfunction with congestive heart failure

    Coding Clinic, First Quarter 2009 Page: 8 Effective with discharges: March 27, 2009



    Question:



    The patient is documented as having systolic dysfunction with acute exacerbation of congestive heart failure (CHF). Can this be coded as acute systolic heart failure with congestive heart failure?



    Answer:



    Assign code 428.0, Congestive heart failure, unspecified and code 428.23, Systolic heart failure, Acute on chronic. Acute exacerbation of a chronic condition (heart failure) is coded as acute on chronic.



    ICD-9-CM's Alphabetic Index provides the following direction for systolic dysfunction with heart failure:



    Dysfunction

    systolic 429.9

    with heart failure -- see

    Failure, heart



    Additionally, congestive heart failure is not an inherent component of systolic or diastolic heart failure. When the diagnostic statement lists congestive heart failure along with either systolic or diastolic heart failure, two codes are required to report the specific type of heart failure: congestive, diastolic, and/or systolic. This advice is consistent with that published in Coding Clinic, Fourth Quarter 2002, pages 52-53 and Fourth Quarter 2004, page 140.





    Sharon Salinas, CCS

    Extension 3336



    From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
    Sent: Tuesday, March 01, 2011 8:32 AM
    To: Salinas, Sharon
    Subject: RE:[cdi_talk] 6485343



    Per Coding Clinic, if you have mention of diastolic dysfunction and CHF you combine them
  • edited May 2016
    THANK YOU SO MUCH!!!




  • "Mild CHF" Drives me crazy! I query that all the time too.

    Greta Goodman
    Clinical Documentation Improvement Specialist
    Health Information Management
    Virginia Hospital Center
    1701 North George Mason Drive
    Arlington, VA 22205
    703-558-5336
    ggoodman@virginiahospitalcenter.com

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