# Cva - with a diagnoses code



## Gemini18 (Mar 5, 2009)

Good Morning -

Can someone please help me with a diagnoses code -

I am working on an discharge audit where the Dr wrote "CVA", the coder coded 434.91.  The discharge diagnoses say "Acute stroke".  Am I right to code 436?


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## fradknot (Mar 5, 2009)

*coder is correct*

I code these the same way 434.91. I never use 436 for a "stroke" the "excludes" under 436  cover a lot of ground and specifies CVA etc and what to use. Hope that helps.

PattyAnn


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## tuffy1 (Mar 11, 2009)

CVA is coded 436.  But if the physician wrote acute stroke then stroke has is own code of 434.91  Hope this helps.


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## RebeccaWoodward* (Mar 11, 2009)

I also use 434.91.

Code 436, Acute but ill-defined cerebrovascular disease, is used when the medical record documents apoplectic attack, cerebral apoplexy, apoplectic seizure or cerebral seizure. 

It is very important to remember that code 436 is no longer the "default" code for CVA or stroke, not otherwise specified. Effective Oct. 1, 2004, the inclusion terms of stroke and CVA under code 436 have been removed and re-indexed to code 434.91

This change was made because physicians use the clinical terms of stroke and CVA synonymously with cerebral infarction. Records also lack specificity in the documentation and the change will allow improved uniformity and statistical data, and prevent unnecessary queries to the physician. Because coders had been accustomed to assigning code 436 for a diagnosis of CVA, when no additional information is available, care must be taken to break this habit because reimbursement will be affected. 

http://health-information.advanceweb.com/editorial/content/editorial.aspx?cc=48130


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