A 68-year-old man with a history of hypertension, chronic obstructive pulmonary disease and coronary artery disease (CAD) was admitted to the hospital for evaluation of atrial fibrillation (AF). While in the hospital, the patient’s AF was controlled using antiarrhythmic drugs. The provider’s final diagnostic statement listed “Chronic persistent atrial fibrillation.” Since there are unique codes for both chronic and persistent atrial fibrillation, which code is more appropriate I48.1, Persistent atrial fibrillation, or I48.2, Chronic atrial fibrillation?
Assign only code I48.1, Persistent atrial fibrillation, as the principal diagnosis. Persistent AF is an abnormal heart rhythm that continues for seven days or longer, or that requires repeat electrical or pharmacological cardioversion. Chronic atrial fibrillation is a nonspecific term that could be referring to paroxysmal, persistent, long standing persistent, or permanent atrial fibrillation. Since code I48.2 is nonspecific, code I48.1 is a more appropriate code assignment.