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  1. Default PVD vs CVD
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    I have been questioned regarding coding PVD 443.9 vs cerebral vascular disease 437.9 from a physician. He feels he can use PVD because intra-cranial atherosclerosis causing end organ damage certainly seems like PVD and can be coded as such vs cerebral vascular disease. Reasoning for this request is that PVD is a HCC dx for risk adjustment and CVD is not. Any thoughts out there? I'm thinking that CVD reflects the specificity of the disease and is the more accurate of the code between the two. Input greatly appreciated.

  2. #2
    Tacoma, WA
    The documentation in the chart is what will determine the final code. PVD is a very specific condition and frequently is found in diabetic patients, which is the reason it is risk adjustable. CVD, or cerebral vascular disease, is generally a condition found in the brain, and although it may affect other areas, it is not primarily PVD, peripheral vascular disease, which presents as pain in the extremeties. It is best to code what is true to the documentation and not try to raise a risk score with a stretch of coding. It would not stand up in audit.

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