Coding "Bezold-Jarish reflex"

robert.hodges2robert.hodges2
edited May 2016 in CDI Talk Archive
I've asked the coders here and still don't have an answer. I had a provider document "Bezold-Jarish syndrome" (which after a quick consult with the provider was clarified as the being the same as Bezold-Jarisch reflex) and was wondering if anyone had a suggestion on how it should be coded?

Thanks in advance.

Robert

Robert S. Hodges, BSN, MSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
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Comments

  • ssalinasssalinas
    edited May 2016
    The Bezold–Jarisch reflex involves a variety of cardiovascular and neurological processes which cause hypopnea (overly shallow breathing or an abnormally low respiratory rate) and bradycardia (abnormally low resting heart rate).[1]

    If there is no code to describe the syndrome, code the documented manifestations separately per General Coding Guidelines (B.17).
  • lspryszaklspryszak
    edited May 2016
    The closest diagnosis for this condition I could find was "neurocardiogenic syncope" which is not listed in the Index or Tabular List of ICD-9. From a search of this disorder it sounds a lot like vasomotor or vasogenic or vasodepressor syncope (all of which are in the ICD-9 Index), which would code to 780.2.

    The condition is not listed in ICD-10, either.

    I discovered the following, which would appear to support using one of the diagnoses above:

    "Bezold-Jarisch Reflex
    A cardiovascular decompressor reflex involving a marked increase in vagal (parasympathetic) efferent discharge to the heart, elicited by stimulation of chemoreceptors, primarily in the left ventricle. This causes a slowing of the heart beat (bradycardia) and dilatation of the peripheral blood vessels with resulting lowering of the blood pressure.

    The concept was originated by a German physiologist Albert von Bezold in 1867, later revised by an Austrian dermatologist Adolf Jarisch in 1937." -- this was on a website for Nurse Anesthesia Review Course (link below):

    http://narc4u.com/index.php/you-asked-we-answered/68-bezold-jarisch-reflex-explained
  • robert.hodges2robert.hodges2
    edited May 2016
    Thanks all. That's what my research found too.

    Robert
     
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