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Cardiac Arrest

  1. Exclamation Cardiac Arrest
    Medical Coding Books
    If a patient comes into the ER in cardiac arrest. He is intubated and transferred to a higher level of care facility, but is still alive, can I code the cardiac arrest? The only other symptoms the patient had were some contusions and the report states the patient was comatose and unresponsive.

    I am confused by the coding clinic notes as follows:

    Cardiac Arrest, 427.5

    Code 427.5, Cardiac arrest (excludes that with pregnancy, anesthesia overdose or wrong substance given, and postoperative complications), may be assigned as principal diagnosis in the following instances:

    ยท If the patient arrives in the hospital's emergency service unit in a state of cardiac arrest, cannot be resuscitated or only briefly resuscitated, and is pronounced dead with the underlying cause of the cardiac arrest not established (cause unknown), code 427.5 is assigned as the diagnosis.

    ยท If the patient arrives at the hospital in a state of cardiac arrest, is resuscitated, and is admitted as an inpatient but dies before the underlying cause of the cardiac arrest is established (cause unknown), code 427.5 is assigned as the principal diagnosis.

    Code 427.5, Cardiac arrest, may be used as a secondary code in the following instances:

    ยท The patient arrives in the hospital's emergency service unit in a state of cardiac arrest and is resuscitated (and admitted) with the condition prompting the cardiac arrest known, such as ventricular tachycardia or trauma. The condition causing the cardiac arrest is sequenced first followed by code 427.5, Cardiac arrest.

    ยท When cardiac arrest occurs during the course of hospitalization and the patient is resuscitated, code 427.5 may be used as a secondary code except as outlined in the exclusion note under category 427.

    Thanks in advance.
    Last edited by JulesofColorado; 04-13-2012 at 01:51 PM.

  2. #2
    Hollywood, CA
    Default cardiac arrest
    Hello, I would code 427.5 as principle as long as the cause of the cardiac arrest is not known. if the condition is known that caused the cardiac arrest I would code 427.5 secondary.

    hope this helps

    Sal V, CCS

  3. #3
    I agree with Sal.

    If there is no known cause (AMI, overdose, trauma) of the cardiac arrest, do you have provider documentation of the patient's arrhythmia (V-fib, asystole, PEA) to code as primary with the 427.5 as secondary? The rhythm disturbance leads to cardiac arrest, the abrupt loss of heart function.

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