Atrial fibrillation (AF or AFib) is the most common arrhythmia (irregular heartbeat) encountered in the critical care environment. It is caused by problems with the heart’s electrical system. AF can lead to longer ICU stay and is associated with an increased risk of mortality. The American Heart Association estimates that about 2.7 million Americans are living with AF. Effective October 1, 2019, ICD-10 category 148 Atrial fibrillation has been expanded from four codes to include more specific options for persistent and chronic atrial fibrillation. To ensure appropriate reimbursement, critical care specialists should be acquainted with new and existing codes and their definitions as well as ensure documentation that reflects the professional services that support the codes. Critical care medical billing and coding services are available to help with this. What is Atrial Fibrillation? Atrial fibrillation is an irregular and often abnormally fast heartbeat that can lead to blood clots, stroke, heart failure and other heart-related complications. Normally, the heart contracts and relaxes to a regular beat (between 60 and 100 beats a minute) when the person is resting. In AF, the upper chambers of the heart beat irregularly and sometimes at a very fast pace, and can be much higher than 100 beats a minute. AF is wide spread among older patients admitted to ICU with chronic conditions who are at risk for critical illness. New-onset AF has been found to be a common complication after cardiac surgery and also occurs among critically ill patients with a high incidence of renal failure and sepsis. Symptoms AF can exist without any symptoms and remain undetected until the person has a medical check-up. The common signs and symptoms of atrial fibrillation are:
AF can cause blood clots, stroke, hypotension, and heart failure with subsequent organ dysfunction. Causes The exact causes of atrial fibrillation are unknown, but it is generally considered the result of high blood pressure and coronary artery disease. Conditions that increase risk of developing AF include:
Since there are different types of arrhythmias, testing using an electrocardiogram (ECG/EKG), Holter monitor, event recorder, or echocardiogram may be ordered to enable correct diagnosis. Identifying AF type will facilitate proper treatment planning. ICD-10 Codes to report Atrial Fibrillation In 2019, there were four codes to report AF:
On October 1, 2020, category I48 was expanded, with more specific options for persistent and chronic atrial fibrillation as follows:
New AF Code Definitions
Coding AF – Key Considerations In 2020, ICD-10 added new codes for chronic, permanent, persistent, and long-standing permanent AF, all of which are CCs (comorbidities/complications). In an inpatient setting, persistent atrial fibrillation needs to be reported as a confirmed diagnosis. A Nov 2019 ACP Hospitalist article discussed key points about using the new ICD-10 codes for AF:
The codes assigned should support medical necessity. Test reports may provide details about a diagnosis not included in the ordering provider’s documentation. In this case, a higher specificity code to support that diagnosis can be reported only if the ordering physician reviewed the results of the test and stated that he/she agreed with the findings (www.findacode.com). Partnering with an expert critical care coding and medical billing service provider is a practical option to ensure correct reporting of atrial fibrillation using the latest codes. What is the ICDICD-10 code I48 for Atrial fibrillation and flutter is a medical classification as listed by WHO under the range - Diseases of the circulatory system .
What is diagnosis code I48 21?“Permanent” atrial fibrillation (I48. 21) is a new code indicating a patient who takes rate control medication with no plans for conversion to sinus rhythm.
What is the ICDICD-10 code Z79. 01 for Long term (current) use of anticoagulants is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
What I48 20?I48. 20 Chronic atrial fibrillation, unspecified - ICD-10-CM Diagnosis Codes.
|