AHA Coding Clinic® for ICD-9 - 2012 Issue 1; Ask the Editor

Diastolic Heart Failure and Atrial Fibrillation

A 78-year-old male patient with history of atrial fibrillation (A-fib) presented to the emergency department with midsternal chest discomfort. He was given sublingual nitroglycerin and aspirin as well as Lasix. At the time of admission, provider documentation indicated diastolic congestive heart failure (CHF) likely due to atrial fibrillation (A-fib). The heart failure resolved with intravenous diuretics and the A-fib was converted to normal sinus rhythm. Both diastolic congestive heart failure and A-fib are listed as discharge diagnoses. In this case, what is the appropriate sequencing of the principal diagnosis? ...

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