Posted By CCF CARDIO MD - APS on December 27, 1998 at 11:10:17:
In Reply to: Coronary Artery Disease posted by CCS on December 22, 1998 at 12:24:09:
As a medical records coder, I am interested in knowing if a person who has had a CABG in the past is still considered to have
CADCoronary heart disease post-CABG whether they have symptoms or not?
Some fiscal intermediaries are requiring more coded diagnoses on
EmergencyEmergency airway puncture
Emergency contraception room records in order for the hospital to be reimbursed for certain diagnostic tests. The code for
CADCoronary heart disease will
supportSupport
Support 500 a good number of the tests commonly performed in the ER.
Often the physician will note: "PMHX:
CADCoronary heart disease, CABG etc... ".
These patients' medication lists will usually indicate that they take
cardiacCardiac catheterization
Cardiac tamponade
Left heart ventricular angiography medicines. In such scenarios, would it be safe to assume that the patient still has an element of CAD, so that we could code it as a secondary diagnosis?
Thanks,
Marta
____
Dear CCS,
Yes, once you have the diagnosis of CAD, you always have it, especially considering that the CABG (or any other revascularization technique) is NOT A CURE, AND THE CAD NOT ONLY REMAINS in every said patient, BUT IT also progresses to involve the grafts in a CABG and the stent/PTCA site, etc.
THIS IS A VERY SIMPLE CONCEPT FOR ANY PERSON WHO HAS GONE TO MEDICAL SCHOOL, it is very disheartening to hear that the people who are doing the coding do not grasp this very simple concept. CAD is a prevalent disease with over 500,000 deaths a year due to it ALONE, and I repeat THERE IS NO CURE FOR CAD, IT IS A CHRONIC DISORDER, SO ONCE YOU HAVE IT, YOU WILL ALWAYS HAVE IT AND BE DEALING WITH IT IN SOME FORM OR ANOTHER.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.