Does anyone have info re selection of principal dx when a pt is admitted with CHF due to severe aortic stenosis? They did do an echo to check on the known stenosis. The pt is end stage and now refuses transfer to a facility that could do valve repair or replacement, our facility does not do them. She is treated for the chf of course and then requests dc to Hospice. It was a 7 day stay and CDI is wanting to go with AS as principal, the coders however feel the reason for the admit was the chf. I am finding very little info to support the argument.
Ellen Douglas, RHIT,CCS
Yes, I'm familiar with that CC and there isn't anything specific re AS that supercedes that I can find either, appreciate the input Lawrence.
You also need to review the treatment the patient had..and the focus of that treatment. If the focus of the treatment was for CHF..even if the cause of the CHF was the AS..then the CHF would be pdx. If, let's say, the patient had a valve replacement also along with the treatment for CHF, then the AS would be pdx.
Sharon Hekimian, RHIT CCS
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Thanks everyone for your input. If we consider that even tho they did the echo to look at the valves (resources) it still was only diagnostic work up, the therapeutic treatment was directed at the chf. If we had the capability and had directly treated the valve then the AS would qualify as principal.