Inpatient rehab CDI resource and question.

Hello-  I am new to CDI and started off in an inpatient rehabilitation hospital.  I am reaching out to see if anyone can help provide resources for inpatient rehab. 

My question is for CHF.  In acute care, specifying acute vs chronic will help with the DRG but in rehab it's not the same situation.  If it is documented as diastolic or systolic, a tier is captured.  Anyone know if I need to be querying for acute and/or chronic?  Hopeful for some feedback!

Thanks !!


  • Hi Nicole,
    Welcome to CDI!  I am not as familiar with the inpatient rehab rules and guidelines but I would like to share with you some Coding Clinic advice that may help answer your question.  If they develop acute CHF they will likely be transferred out of rehab to the medical floor.  I would not query a physician for the acuity of CHF unless I have clinical indicators to support acute, so my guess is that in the rehab setting you will not see it as often.  
    History of diastolic congestive heart failure

          ICD-9-CM Coding Clinic, Third Quarter 2008 Page: 12 to 13 Effective with discharges: September 19, 2008




    When a patient has a known history of diastolic congestive heart failure (CHF), how would this be coded?




    Assign code 428.32, Diastolic heart failure, chronic, and code 428.0, Congestive heart failure unspecified. This is coded as chronic due to the patient's known history..

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