hypercoagulable state
We have been asked to query for hypercoagulable state due to afib per coding clinic second quarter 2021
The physicians are stating that afib is not a hypercoagulable state but a stasis of blood. We have provided education regarding secondary hypercoagulable state. Any additional teaching points to help physicians would be appreciated.
Comments
I have had that scenario quite a few years ago. I thought the same as the doctors. It's a mechanical think not a clotting abnormality. i found a presentation online of a consultant company who was advocating for that practice. I wrote to them but never got a reply. It seems shady to me. Maybe there is a great rationale out there but no one has ever been able to provide it to me.
This is from a Oct. 2019 response to another question:
An open-ended query may be made to ask the clinical significance of ‘CHADSVASC score of >1’ and if a diagnostic statement is made, then the clinical rationale must be documented. I would add that ‘prophylactic treatment’ for prevention of thrombosis does not indicate that ‘hypercoagulable state’ is a current condition, only that the patient has a risk for future thrombosis.
Another issue with this particular scenario is that, by itself, Atrial Fib does not cause a systemic hypercoagulable state. It suggests a propensity for localized clot formation, but it is not a cause of a systemic hypercoagulopathy. The CHADSVASC is a ‘risk’ score suggesting the need for anticoagulation; it is not a clinical indicator of a diagnosis.