# Cardiac Dx Help



## JOgielo (Mar 2, 2011)

Patient has shocks as a result of an implantable cardiac defibrillator.  How would this be coded?  WOuld it be shock 785.50, cardiogenic shock 785.51 or would I look at the mechanical device complication codes?  Would love an opinion on this.  thanks.


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## eadun2000 (Mar 2, 2011)

JOgielo said:


> Patient has shocks as a result of an implantable cardiac defibrillator.  How would this be coded?  WOuld it be shock 785.50, cardiogenic shock 785.51 or would I look at the mechanical device complication codes?  Would love an opinion on this.  thanks.



996.04 Mechanical complication due to automatic implantable cardiac defibrillator
E878.1 Surgical operation, implant artificial internal device, with abnormal reaction/later complication, no surgical misadventure

Hope this helps!


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## JOgielo (Mar 2, 2011)

It does, thanks so much for responding to my post so quickly.


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## dclark7 (Mar 8, 2011)

I beg to differ with the above opinion.  An AICD is designed to deliver a shock whenever the patient's heart rate falls outside of the programmed limits.  (They do basically the same job as the defibrillators used for a cardiac arrest). Unless there truly is a malfunction in the unit you should code the reason the patient received the shock, ie. tachycardia, SVT, A-Fib, bradycardia  or whatever.  If a patient receives a shock from the AICD the device is then interrogated to discover the reason.  Careful review of the medical record, or a query to the provider should give you your answer.  You should only code 996.04 if the AICD is actually malfunctioning and this too should be clearly stated in the medical record.


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## eadun2000 (Mar 8, 2011)

dclark7 said:


> I beg to differ with the above opinion.  An AICD is designed to deliver a shock whenever the patient's heart rate falls outside of the programmed limits.  (They do basically the same job as the defibrillators used for a cardiac arrest). Unless there truly is a malfunction in the unit you should code the reason the patient received the shock, ie. tachycardia, SVT, A-Fib, bradycardia  or whatever.  If a patient receives a shock from the AICD the device is then interrogated to discover the reason.  Careful review of the medical record, or a query to the provider should give you your answer.  You should only code 996.04 if the AICD is actually malfunctioning and this too should be clearly stated in the medical record.



Please re-read the above question.. it states SHOCKS not a (as in one) shock.


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## margarete (Mar 10, 2011)

dclark7 said:


> I beg to differ with the above opinion.  An AICD is designed to deliver a shock whenever the patient's heart rate falls outside of the programmed limits.  (They do basically the same job as the defibrillators used for a cardiac arrest). Unless there truly is a malfunction in the unit you should code the reason the patient received the shock, ie. tachycardia, SVT, A-Fib, bradycardia  or whatever.  If a patient receives a shock from the AICD the device is then interrogated to discover the reason.  Careful review of the medical record, or a query to the provider should give you your answer.  You should only code 996.04 if the AICD is actually malfunctioning and this too should be clearly stated in the medical record.


thanks dclark7 for the very clear explanation on how to code both scenarios. I had one today and the patient was transferred to determine just what was happening. Since my provider documented the defibrillator was firing most likely due to v. tach I did have a dx to use (inpt coding) along with the v code for the device.


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