# Paroxysmal Atrial Fibrillation



## Ryan.Abdul@miramedgs.com (Jun 12, 2016)

Good day!

Patient with history of Paroxysmal Afib for a year admitted today with other complain, however,  Paroxysmal Afib still documented in assessment but normal sinus rhythm upon admission with meds (beta blockers). Do we still code this as Paroxysmal since by medical definition, ''it is an episode of uncoordinated movement of the atria that occurs occasionally and then stops. Episodes can last from minutes to days before stopping and returning to normal “sinus” rhythm.'' or Atrial Fibrillation unspecified only? 

Thank you!


Ryan Abdul, RN, CIC


----------



## Dhaneshmurali (Jun 13, 2016)

Hi,


There is no documentation of Paroxysmal Atrial fibrillation has been resolved and no evidence of provider documentation of monitoring/survilence of A.fib condition. So as long as the patient taking medication for the particular condition we can take the condition.


Anyother suggestion are welcome.!!


Regards,
M Dhanesh CPC


----------



## Ajesh Kuriakose (Jun 13, 2016)

Since the physician documented it you will have to code. That would be my direct answer.


----------



## Ryan.Abdul@miramedgs.com (Jun 13, 2016)

Dhaneshmurali said:


> Hi,
> 
> 
> There is no documentation of Paroxysmal Atrial fibrillation has been resolved and no evidence of provider documentation of monitoring/survilence of A.fib condition. So as long as the patient taking medication for the particular condition we can take the condition.
> ...





Hi, thank you for your response. But what if the doctor documented it only in past history then only written now in Assessment as ''Paroxysmal Afib: normal rhythm, continue taking beta blockers'', can we still code this as Paroxysmal Afib? Thanks.


----------



## CodingKing (Jun 14, 2016)

As you stated (I Love it when Coders are RN's BTW) PAF is defined as at least two separate episodes of AF that terminate spontaneously in less than 7 days, usually within 24 hours. What the physician is saying by normal rhythm is that patient is currently not having an episode. Beta Blocker is a the treatment option keeping it under control. This is active treatment for the condition so you would code it.

You would not use unspecified as that means the physician doesn't know or has not documented the type.


----------



## Ryan.Abdul@miramedgs.com (Jun 22, 2016)

Great thinking and response. Thank you!

So yes we can still code it, but do you think the age of Paroxysmal Afib is significant? Let me say for example that he was diagnosed 5 years ago with Paroxysmal Afib and currently in normal rhythm but taking meds?


----------



## lucihoo (Oct 24, 2018)

*Paroxysmal Afib*

Think of it this way, if its not documented as a one time occurrence or as resolved or as resolved by ablation, AND the patient is taking a med to control the afib, its being managed still and obviously still present. Any time a medication is being taken for a condition its almost always a code-able condition. Take away the med and likely the patient is right back in acute afib or whatever the condition is, not to mention the provider is still managing the ongoing condition! Theyre still prescribing, still examining for sxs, still taking into consideration when dx'ng other conditions-aka: MDM. I'm sure that provider wouldn't appreciate doing that work every time they see that patient but a CPC decided because the med is keeping sxs at bay that doc shouldn't get reimbursed for their time managing the afib! Meant to be funny, but also get a point across, I hope it did!


----------

