Cardiovascular Conditions and CDI Opportunities

Jennifer Jones, RHIT, CCS, CCDS CDI Leave a Comment

Cardiovascular Conditions and CDI Opportunities

There are several cardiovascular diseases that contribute to death in the United States and also are the leading cause of death. According to the Centers for Disease and Control (CDC), 1 in every 4 deaths are due to heart disease.

The most common cardiovascular disorder is coronary artery disease (CAD), and in fact a heart attack or myocardial infarction (MI) occurs every 40 seconds. When a coronary artery is blocked, the lack of blood flow to the heart causes the heart tissue to die. This is known as an (MI). A few clinical indicators of an MI include chest pain, epigastric pain, jaw pain, radiation of pain down the left arm, diaphoresis, elevated cardiac markers, and even nausea and vomiting. There are several different types of MIs. Specificity with CDI involvement or query may be needed to clarify type, site, and underlying cause. Treatment could include hearth catheterization, PTCA with or without stent, atherectomy, or CABG.

Another cardiovascular disease is congestive heart failure (CHF), and this occurs when the heart is not able to pump an adequate supply of blood and oxygen to support the rest of the body, causing fluid to build up around the heart, which in turn affects the heart muscle and its ability to pump blood. According to the CDC, 1 in every 8 deaths are due to heart failure in the United States. Some risk factors include CAD and MI, diabetes, elevated blood pressure, obesity, and valvular heart disease. Clinical indicators include (but are not limited to) shortness of breath, fatigue or weakness, elevated BNP, and edema in the lower extremities. Specificity is also important when coding CHF, and documentation of type (systolic, diastolic, etc.) and acuity (acute, chronic, decompensated, etc.) should be documented. CDI and query involvement may be necessary to obtain this documentation. Treatment depends on the underlying cause of the CHF, and could include CABG, heart valve surgery, medications and possibly even a heart transplant.

Valvular heart disease is a condition that affects about 2.5% of the US population according to the CDC and cause nearly 25,000 deaths per year. Valvular heart disease is when a valve is diseased or damaged, which then causes the valve to not fully close or open during a heartbeat, to incompletely close (regurgitation) or is stiff and narrow due to stenosis. These conditions can be caused by rheumatic disease, infection, congenital conditions, heart failure, atherosclerosis, and elevated blood pressure to name a few. Symptoms include shortness of breath, chest pain, fatigue, irregular heartbeat, dizziness, or fainting. Clarification with providers regarding stenosis or insufficiency, rheumatic or non-rheumatic involvement, and even specificity of the valve (mitral, aortic, tricuspid, etc.) may need to be obtained by query or CDI. Treatment includes medications, surgery or possibly even heart valve replacement.

REFERENCES: https://www.cdc.gov/heartdisease/facts.htm; https://www.cdc.gov/heartdisease/heart failure.htm; https://www.cdc.gov/heratdisease/valvulardisease.htm.

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