Afib changes for 2020

Hi,
Looking over the new classifications for afib, I have a question and i hope the forum can help me.  
If we have a patient with a history of afib for longer than 12 months and is maintained on medication, can we 'assume' that this is Chronic afib or would we need to query the provider for specificity?  This would be a similar 'assumption' to the CHF patient that has a history of CHF and is maintained on medication is Chronic.    

Definitions:

  • Paroxysmal afib: This is when the heart returns to a normal rhythm on its own or with intervention within seven days of its start. People who have this type of afib may have episodes only a few times a year or their symptoms may occur every day. This would be reported with ICD-10-CM code I48.0 (paroxysmal afib).  This is not a CC. 
  • Longstanding persistent afib: This is diagnosed when the condition lasts longer than a year. Medicine and treatment like electrical cardioversion won’t eliminate the afib. Normal heart rhythm will have to be restored with some other kind of treatment, like surgery. This is reported with the ICD-10-CM code I48.11, which will be new for FY 2020. This code will also be a CC condition.
  • Persistent afib: This is an irregular rhythm that lasts for longer than seven days. This type of afib will not return to normal sinus rhythm on its own without treatment. Persistent afib can be reported with codes from ICD-10-CM subcategory I48.1- (persistent atrial fibrillation), which will be a new subcategory for FY 2020. This will now be a CC
  • Chronic afib: This is an irregular rhythm that lasts for longer than 12 months, and it is reported with a code from ICD-10-CM code subcategory I48.2-, which will also be new for FY 2020. This code will also be a CC condition.
  • Permanent afib: This is a condition where the afib persists despite treatment to restore normal sinus rhythm or afib that is not treated. This condition can be reported with ICD-10-CM code I48.21, which will be new for FY 2020. This code will also be a CC condition.
Thank you in advance for your help with this,

Patty

Patricia Matson Vitasinski RN CCDS

Manager, CDI Quality Improvement

Henry Ford Health System

1414 East Maple

2 East-136

Troy, MI 48083

(248) 648-7346 office

(248) 961-2178 cell

Pvitasi2@hfhs.org


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