acute core pulmonale

kerryseekircherkerryseekircher
in CDI Talk Archive
I'm having trouble coding acute cor pulmonale-it is coding to 'other pulmonary embolism with acute cor pulmonale'=12609.
Any guidance on what to do-I don't want to code this in a patient that does not have a PE?
Thanks,
Kerry

Kerry Seekircher, RN, BS, CCDS, CDIP
Clinical Documentation Program Manager
Northern Westchester Hospital
400 East Main Street
Mount Kisco, NY 10549
Email: kseekircher@nwhc.net
Phone: 914-666-1243
Fax: 914-666-1013

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Comments

  • kwilliams@halifaxrmc.orgkwilliams@halifaxrmc.org
    edited March 2016
    In 10 Acute Cor Pulmonale is not reportable in the absence of a PE.


    Kim Williams, RN
    Clinical Documentation Specialist
    Halifax Regional
    Revenue Management Department
    kwilliams@halifaxrmc.org
    (252) 535-8154
    (252) 535-8937 fax

    [cid:image001.jpg@01D1333E.EBA3BB20]




  • kbenson@uwhealth.orgkbenson@uwhealth.org
    edited March 2016
    Kerri,
    I hate to be the bearer of bad news, but there is no code for Acute Core Pulmonale that is not connected to a PE. The ICD-10 people have received many requests to change this.
    Kathy

    Kathleen Benson RN, BSN, CCDS
    Supervisor, Clinical Documentation Integrity
    UWHealth University of Wisconsin Hospital
    Office Location: University Crossing, 749 University Row, Suite 200
    Mailing Location: 600 Highland Avenue, Mail Code 9920
    Madison, WI 53792-9475
    608-516-5638
    kbenson@uwhealth.org



  • Linda_RhodesLinda_Rhodes
    edited March 2016


    Hi Kerry,
    I listened to a webinar yesterday that addressed this issue. Acute Cor
    Pulmonale is not reportable in the absence of a PE. My understanding is
    that this may be corrected in the future but that is the current state.
    Thanks,
    Linda

    k.com> 12/10/2015 11:33 AM >>>

    I’m having trouble coding acute cor pulmonale-it is coding to ‘other
    pulmonary embolism with acute cor pulmonale’=12609.
    Any guidance on what to do-I don’t want to code this in a patient that
    does not have a PE?
    Thanks,
    Kerry

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013

    Celebrating 100 Years of Care in our community
    #NWH100YearsOfCare





  • Unknown
    edited March 2016
    And it has to be a massive pulmonary embolism – where the flow through the major pulmonary arteries is almost totally blocked, causing acute dilation of the right ventricle. Without this dilation, there is no acute cor pulmonale. The condition can occur in ARDS, too – but very few other sudden, massive events will cause it.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

  • catladyrncatladyrn
    edited March 2016
    Yes, there is a coding clinic.

    Acute cor pulmonale due to pulmonary hypertension w/o mention of pulmonary embolus

    Coding Clinic, Fourth Quarter ICD-10 2014 Pages: 21-22 Effective with discharges: December 31, 2014

    Question:

    A patient with a known history of pulmonary hypertension, chronic obstructive pulmonary disease and cor pulmonale presents with new-onset shortness of breath, increasing peripheral edema and severe abdominal distension due to decompensated right heart failure. The patient was treated with aggressive diuresis and oxygen supplementation. The physician listed “right heart failure, decompensated cor pulmonale secondary to severe pulmonary hypertension” in his final diagnostic statement. How should acute cor pulmonale be coded when there is no documentation of pulmonary embolism?

    Answer:

    Assign code I50.9, Heart failure, unspecified, as the principal diagnosis for the right heart failure. Assign codes I27.81, Cor pulmonale (chronic), I27.2, Other secondary pulmonary hypertension, and J44.9, Chronic obstructive pulmonary disease, unspecified, as additional diagnoses.

    ICD-10-CM’s Index references code I27.2 under “pulmonary hypertension with cor pulmonale.” Unfortunately the Index under “pulmonary hypertension with acute cor pulmonale” leads to code I26.09, Other pulmonary embolus with acute cor pulmonale. In this case, code I26.09 is not appropriate since the patient does not have a pulmonary embolism.


    The National Center for Health Statistics (NCHS), the organization responsible for ICD-10-CM, will consider a future C&M proposal to modify the codes describing pulmonary embolism with cor pulmonale.

    Renee

    Linda Renee Brown, RN, MA, CCDS, CCS, CDIP
    Director, Clinical Documentation
    Tanner Health System
  • kbenson@uwhealth.orgkbenson@uwhealth.org
    edited March 2016
    Awesome, thanks Renee!


    Kathleen Benson RN, BSN, CCDS
    Supervisor, Clinical Documentation Integrity
    UWHealth University of Wisconsin Hospital
    Office Location: University Crossing, 749 University Row, Suite 200
    Mailing Location: 600 Highland Avenue, Mail Code 9920
    Madison, WI 53792-9475
    608-516-5638
    kbenson@uwhealth.org


  • kerryseekircherkerryseekircher
    edited March 2016
    Okay-unfortunate, but makes sense not to report it in these circumstances where a PE is not present.
    Thanks,
    Kerry

    Kerry Seekircher, RN, BS, CCDS, CDIP
    Clinical Documentation Program Manager
    Northern Westchester Hospital
    400 East Main Street
    Mount Kisco, NY 10549
    Email: kseekircher@nwhc.net
    Phone: 914-666-1243
    Fax: 914-666-1013

    Celebrating 100 Years of Care in our community
    #NWH100YearsOfCare





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