AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 2; Ask the Editor
Cerebral Artery Infarction with Hemorrhagic Conversion
A patient was given tPA after being admitted through the emergency department (ED) for sudden onset of weakness and difficulty speaking. The provider diagnosed ischemic infarction of the left posterior cerebral artery. A repeat computed tomography (CT) scan showed hemorrhagic conversion of the left posterior cerebral artery ischemic stroke. When the provider was queried regarding cause and effect between the tPA and the hemorrhagic conversion, he responded that there was no relationship; the hemorrhage occurred after the tPA had worn off. What is the diagnosis code assignment for the hemorrhagic conversion? ...
Subscribe or sign in to view the full article.
Article Overview
This article discusses diagnosis coding for a stroke case involving an ischemic cerebral infarction, treatment with thrombolysis, and a later hemorrhagic conversion that is determined not to be an adverse effect of the drug. It is relevant to inpatient and emergency department coding professionals, CDI specialists, and anyone working with stroke-related diagnosis assignment and clinical documentation clarification. The article focuses on how the documented clinical relationship between treatment and bleeding affects the coding approach.
Why This Topic Matters
Stroke cases with hemorrhagic conversion often require careful review of documentation to understand the relationship between the infarction, treatment, and bleeding event. Accurate diagnosis assignment depends on distinguishing the underlying stroke condition from a separately documented hemorrhagic finding.
What You Will Learn
- How the article frames a stroke case with hemorrhagic conversion after thrombolytic treatment.
- How documentation clarification affects the diagnosis-coding approach.
- How the article addresses assignment of the underlying cerebral infarction diagnosis.
- What factors are considered when the provider states the hemorrhage is not related to tPA.
Who Should Read This
- Inpatient coders
- Emergency department coders
- Clinical documentation integrity specialists
- Coding auditors
- HIM professionals
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com