Health Information Management

News: Coding Clinic reverses stance on heart failure code assignment

CDI Strategies, April 7, 2016

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Coders can now appropriately assign a code for diastolic or systolic heart failure, as warranted if the physician documents heart failure with preserved ejection fraction (HFpEF), heart failure with reduced ejection fraction (HFrEF) (respectively), or a combination of both, if indicated, according to the AHA’s Coding Clinic for ICD-10-CM/PCS, First Quarter, 2016, p. 10.

The Coding Clinic Editorial Board previously advised coders to query the physician, stating that they “cannot assume either diastolic or systolic” with the HFpEF/HFrEF documentation.
The new guidance comes on the receipt of additional information from the American College of Cardiology. “These terms HFpEF and HFrEF are more contemporary terms that are being more frequently used,” Coding Clinic said.
“It is always a good day when the coding instruction reflects the language used by our providers,” says Laurie L. Prescott, RN-MSN, CCDS, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer, CDI Education Director for HCPro/ACDIS in Danvers, Massachusetts. “I often joked that I would be asking for differentiation of systolic versus diastolic on my death bed. But this latest Coding Clinic offers us assistance in obtaining this differentiation.”
With the new guidance taking effect for discharges after March 18, 2016, Prescott says CDI specialists could possibly be looking forward to asking at least one less query. 

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