AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor
Intermittent Complete Heart Block
This patient presented to the emergency department following episodes of syncope. The patient had runs of asystole while on cardiac monitor with loss of consciousness. On the telemetry strips the patient was found to have normal sinus rhythm with periods of complete AV block with ventricular asystole. At the time of consultation the patient was in normal sinus rhythm with an underlying first degree AV block and a second degree type II AV block. Physician’s documentation states that the patient goes in and out of second degree heart block. The placement of a permanent pacemaker was discussed but the patient refused. What is the correct code assignment for intermittent complete heart block when a patient goes in and out of second degree heart block type II, and has an underlying first degree heart block? Is it appropriate to assign only code 426.0, AV block complete, or should code 426.12, Mobitz (type) II AV block, and code 426.11, First degree AV block, be assigned as additional codes? ...
Subscribe or sign in to view the full article.
Article Overview
This article addresses medical coding considerations for a patient evaluated after syncope and telemetry-documented conduction abnormalities, including alternating rhythms and documentation of multiple AV block patterns. It is aimed at coders, auditors, and clinical documentation specialists who need to understand the scope of the case and the related diagnosis-coding discussion without relying on the premium text.
Why This Topic Matters
Accurate diagnosis coding for fluctuating cardiac conduction findings depends on careful interpretation of the documented rhythm pattern and the clinician’s terminology. This article helps readers identify whether the case is about a single diagnosis versus a combination of related heart-block findings.
What You Will Learn
- How an intermittent heart block case is framed for coding review
- How documentation language can affect diagnosis code selection
- How mixed conduction findings are discussed in an emergency department context
- How the article approaches the relationship between telemetry findings and coding questions
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation specialists
- Revenue cycle staff
- Cardiology coding staff
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com