CHF 2/2 A Fib.

dsmith12h@aol.comdsmith12h@aol.com
in CDI Talk Archive
I need some education. If a patient is admitted with Acute on chronic systolic heart failure 2/2 to afib and both are treated. The aptient received RHC/Ablation for A.Fib. How would you sequence the codes? What would be chosen for the PDx?

Comments

  • dvitalone1dvitalone1
    edited May 2016
    A fib with MCC of a/c sys heart failure as secondary

    The key is that there is documentation of heart failure DUE TO a fib



  • cynthia.a.goeweycynthia.a.goewey
    edited May 2016
    I would use the afib with the A/C systolic CHF as a MCC since the provider stated the CHF was due to the afib.
    Thanks,

    Cindy

  • ssalinasssalinas
    I would use the Afib as principal since an ablation was performed. If there were no procedure and treatment was focused on controlling the 428.23 with medication, then I would say that (428.23) was the principal. If treatment was focused on controlling the afib, that is the principal.

    Sharon
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    I would also review for IV treatment at the time of admission to treat
    and control the fib and the failure - use of IV medication to treat the
    Fib could also strengthen the argument this as an 'acute' condition
    causing the acute CHF.




    Paul Evans, RHIA, CCS, CCS-P

    Supervisor, Clinical Documentation Integrity, Quality Department
    California Pacific Medical Center
    2351 Clay #243
    San Francisco, CA 94115
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org
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