hypertension and CHF

tkreilingtkreiling
in CDI Talk Archive
A pt is admitted with acute CHF (no h/o of CHF is noted) with BP's running 209-228 systolic and 77-89 diastolic for first 7 hours at admit. BP was elevated at care center per family. CV and renal have been consulted and BP meds have been adjusted. Would this be an appropriate time to ask if CHF is due to HTN?

Thanks,
Tara

Comments

  • dvitalone1dvitalone1
    edited May 2016
    I think no, you should wait for consults then if there is no link query
  • tkreilingtkreiling
    edited May 2016
    The consults have dictated and there is no link mentioned, they only adjusted meds.
    Thanks.
  • digardskdigardsk
    edited May 2016
    Try to get the link and get to cardiorenal syndrome as pdx. You can use the acute CHF as mcc with it.
  • tiffany.andrastiffany.andras
    edited May 2016
    I would look for the consulting documentation, and if not mention as a cause and effect then, I would try verbal communication with the cardiologist first.
    I speak to our cardiologist on these types of cases when not linked. With the clinical picture, results and the medications used for treatment, you then maybe can get them to place the linkage if appropriate.

    Tiffany Andras LPN

    Thibodaux Regional Medical Center
    Clinical Documentation Nurse
    985-493-4593
  • tiffany.andrastiffany.andras
    edited May 2016
    I agree I would try to get the cardiorenal syndrome.

    Thibodaux Regional Medical Center
    Clinical Documentation Nurse
    985-493-4593
  • tkreilingtkreiling
    edited May 2016
    Thanks,
    I have not queried in for a linkage of CHF and HTN before so I just wanted to make sure it was appropriate in this instance. (trying to step out of my box of the routine CHF type, CKD stage queries,etc.)
    Thank you!
  • katysuegood@gmail.comkatysuegood@gmail.com
    Can someone provide an example query for Cardiorenal syndrome? Do you use checkboxes with options for this or are you simply stating the clinical indicators and hoping the MD comes up with the appropriate terminology?

    Thanks!

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • kmaritankmaritan
    edited May 2016
    I've had success with the choices for this scenario:

    If the heart failure (or other heart disease) is due to
    hypertension
    If the current overall cardiac picture represents hypertensive
    heart disease
    No link between heart failure (or other heart disease) and
    hypertension
    Other (please document)
    Unable to determine

    Please remember to ask for the CHF type always.
    Another point: if CKD is documented (and do not need link to either HF
    or HTN) as well as hypertensive heart disease from your query response,
    it will bring you to the 404.xx codes (Hypertensive heart and chronic
    kidney disease). This then becomes principal diagnosis within CHF DRG's
    (291-293). Then the acute (type) CHF is allowed as MCC within its own
    CHF DRG's. Doesn't make sense but see ICD-9 code book for code 404.xx
    that shows the CHF specificity is coded as an additional code after the
    404.xx code. Let's enjoy while we can until the powers that be discover
    this and take it away. :)

    Karen Maritano, R. N.
    Clinical Documentation Specialist
    Legacy Health
    Portland, Oregon
    503-413-7154
  • digardskdigardsk
    edited May 2016
    Make sure you get the kidney disease documented, the link is presumed with HTN and kidney dz. Then, see if you can query for the link between HF & HTN. If they say cardiorenal great, but if you put in a grouper / 3M it will code to cardiorenal and put the acute (specified) CHF as mcc.
  • ssalinasssalinas
    edited May 2016
    Acute CHF doesn't get you anywhere unless it is identified as diastolic,
    systolic or combined.
Sign In or Register to comment.