 AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 3; Ask the EditorA patient is admitted for treatment of chronic atrial fibrillation (AF) with rapid ventricular response (RVR). The classification provides codes that describe paroxysmal, chronic, and persistent atrial fibrillation, but not atrial fibrillation with rapid ventricular response. A diagnosis of chronic AF with RVR seems to indicate severity. Would it be appropriate to assign code I48.0, Paroxysmal atrial fibrillation, for AF with RVR? If not, what code should be assigned to reflect chronic atrial fibrillation with RVR? ... Show
To read the full article, sign in and subscribe to AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS . Thank you for choosing Find-A-Code, please Sign In to remove ads. This Coding Tip was updated on 8/12/2022 With the implementation of ICD-10-CM came more codes for reporting many different conditions and diseases, and atrial fibrillation is one of those. For many years there was only one code available for reporting this condition, even when the physician further specified the type of atrial fibrillation that the patient had. In ICD-10-CM, there are four codes to report atrial fibrillation:
What is atrial fibrillation?Atrial fibrillation is an irregular heartbeat or arrhythmia sometimes called a quivering heart. This arrhythmia can cause a patient to develop blood clots, have a stroke, heart failure or other conditions. The heart rate is most often rapid and causes poor blood flow. When a patient is in atrial fibrillation, the upper chambers of the heart (atria) are beating differently than the lower chambers (ventricles). When this occurs, the irregular rhythm/heartbeat, prohibits the atria from contracting/relaxing and causes ineffectual filling and emptying of the ventricles. This is referred to often as a chaotic dysrhythmia. The cause of atrial fibrillation is oftentimes unknown but can be the result of damage to the heart’s electrical system caused by conditions such as uncontrolled hypertension and coronary artery disease. Atrial fibrillation can develop in any person including children, but the risk is higher in patients of advanced age, have hypertension, have underlying heart disease, binge drinking of alcoholic beverages, family history, sleep apnea sufferers, athletes, patients with thyroid disease, diabetes and asthma are some of the more common diseases that put a patient at higher risk for developing atrial fibrillation. Controlling the disease that causes the erratic heartbeat is a must, as well as treating the arrhythmia. Sometimes treating and controlling the underlying cause will make the atrial fibrillation go away. If this does not help the erratic rhythm, then the patient may require treatment with beta blockers and calcium channel blockers to help slow the heart rate. The rhythm should be restored to a normal rhythm to reduce the high heart rate. Patients are often placed on a blood thinner to help prevent blood clot and stroke in addition to the rate and rhythm controller medication. The rhythm should be restored to a normal rhythm to reduce the high heart rate. There are other treatments available such as electrical cardioversion, radiofrequency/catheter ablation, pacemakers and an open-heart maze procedure for the atrial fibrillation that does not correct on its own or does not respond to the medications. How to code multiple documented types of atrial fibrillation?The most recent coding advice has addressed how to report the appropriate code for the atrial fibrillation when more than one type is documented. Per this advice, if the physician diagnoses the patient with chronic persistent atrial fibrillation only the code I48.19(other persistent atrial fibrillation) is reported. The term chronic is a nonspecific term that could also be used to describe the other types of specified atrial fibrillation. Since I48.19 is a more specific code this is the one that should be reported. Even though the Alphabetic Index within ICD-10-CM has listed the different types of atrial fibrillation at the same indention level, only one code is reported. The most specific term should be reported. Atrial Fibrillation Coding Tips:
There are other examples of how to code atrial fibrillation when multiple types are documented in the latest issue of Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2019: Page 7. References The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly. What is paroxysmal atrial fibrillation with RVR?Some cases of Afib involve atrial fibrillation with rapid ventricular response (RVR). This is when the rapid contractions of the atria make the ventricles beat too quickly. If the ventricles beat too fast, they can't receive enough blood. So they can't meet the body's need for oxygenated blood.
What is the difference between AFib and AFib with RVR?In people with A-fib, the heart beats irregularly and often too quickly, getting out of sync with the two lower chambers. A-fib episodes can come and go or become persistent and require medical treatment. In a case of A-fib with RVR, the faulty electrical signals are not confined to the upper chambers of the heart.
What is the ICDI48. 0 - Paroxysmal atrial fibrillation | ICD-10-CM.
Is paroxysmal atrial fibrillation the same as atrial fibrillation?Atrial fibrillation (AFib) is a type of irregular heartbeat. If you have it, your doctor will classify yours by the reason for it and on how long it lasts. When your heartbeat returns to normal within 7 days, on its own or with treatment, it's known as paroxysmal atrial fibrillation.
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Icd 10 code for paroxysmal atrial fibrillation with rvr
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