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Cardiology Coding Alert

Reader Question:

Coumadin and Surgery

Published on Sat Dec 01, 2001

Question: How should I code a coumadin patient who must be admitted to the hospital to stop coumadin and to be heparinized prior to surgery?

Idaho Subscriber

Answer: The primary code should be the reason the patient is on coumadin, which could be a heart valve (V43.3), atrial fibrillation (427.31), coronary atherosclerosis of native coronary artery (414.01), or something else. And V58.61 (long-term [current] use of anticoagulants) should be submitted as the second diagnosis. A third diagnosis, describing the reason for the surgery for which the patient is being heparinized, should be listed third.
 
Using V43.3 as the primary code is reasonable because it is a reimbursable diagnosis, unlike many other V codes. Codes relating to the reason the prosthetic valve was implanted should not be used because the prosthetic valve has remedied the condition.

  You Be the Coder and Reader Questions were answered by Sandy Fuller, CPC, a cardiology coding specialist with Cardiology Consultants, a nine-physician practice in Abilene, Texas; Sandy Rubio, RN, CPC, a cardiology coding specialist in Omaha, Neb.; Rebecca Sanzone, CPC, billing manager with Mid-Atlantic Cardiovascular Associates, a 58-physician practice in Baltimore; Savannah Siens, CPC, CCS-P, a cardiology coding specialist in Kansas City, Mo.; and Nikki Vendegna, CPC, a cardiology coding and reimbursement specialist in Overland Park, Kan.

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