# Edema - Cardio or Musculoskeletal??



## stacey.baxter

Can someone please clarify proper use of Edema for General Multi-system Exam?
I have been told that it can ONLY be used for a bullet under Cardiovascular (Extremities for edema and/or varisocities) and I've also been told that you can use it under Cardio OR Musculoskeletal for extremities.  

What is the correct answer and is there any place I can reference this information?

Thanks!!


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## jackson7591

*Edema*

Would have to look at recent patient history.  Edema may be the result of decreased activity, i.e. bed rest, prolonged travel, anything that impairs local or general skeletal muscle activity (reference skeletal muscle pump.)  In the absence of decreased skeletal muscle activity, the next most likely cause of edema besides electrolyte imbalance (sodium) is cardiac related; right vs left ventricular failure.  the type of edema if it is cardiac related, pedal (right ventricular failure), jugular venous distention (jvd) ((left ventricular failure)).

In short, edema is not necessarily a cardiac issue.


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## FTessaBartels

*1997 vs 1995 guidelines*

The 1997 guidelines specifically include "extremities for edema or varicosities" as a bullet under CARDIOVASCULAR system.

The 1995 guidelines are not so specific.  So you might be able to argue that noting extremity edema is Musculoskeletal ... all depends on the documentation.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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