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CVA-Cerebral Vascular Accident: Difference between revisions

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{{DX tag | Neurological Problem | [[:Category: Medical Problem | Medical Problem]] | CVA-Cerebral Vascular Accident | Yes see: [[:Category:CVA-Cerebral Vascular Accident | CVA-CEREBRAL VASCULAR ACCIDENT]] | [[50500 -CVA-Cerebral Vascular Accident]] | Yes see: [[:Category: Comorbid Diagnosis | Comorbid Diagnosis]] | 1 | CC & Med | Currently Collected |  | }}
Strokes
{{PreICD10 dx | NewDxArticle = Cerebral infarction/stroke due to embolism}}
{{PreICD10 dx | NewDxArticle = Cerebral infarction/stroke, NOS}}
{{PreICD10 dx | NewDxArticle = Stroke, NOS}}
{{PreICD10 dx | NewDxArticle = Subdural or epidural hematoma/hemorrhage, nontraumatic}}
{{PreICD10 dx | NewDxArticle = Hemorrhage, intracerebral/intracranial, nontraumatic (ICH, hemorrhagic stroke)}}
{{PreICD10 dx | NewDxArticle = Hemorrhage, subarachnoid or ruptured cerebral aneurysm}}  


== Co-coding paralysis ==
{{Discussion}}
'''Question''' re: coding for CVA. When admitting a patient with a diagnosis of cva (or other types of cerebral bleed for that matter), do you also include [[Paraplegia, Hemiplegia]] (#537) in your admit diagnosis list?[[User:DPageNewton|DPageNewton]] 21:06, 28 January 2010 (CST)


=== Yes ===
{{DX tag | Neurological Problem | Medical Problem | CVA-Cerebral Vascular Accident | Yes |
*I have been collecting on the unit that admits the stroke 25 patients+/- post tpa. If the patients are paralysed on one side because of the acute stroke I code it after putting CVA in the first spot. I have done it this way for the last 5 years.[[User:GHall|GHall]] 13:27, 1 February 2010 (CST)
* 50500 - CVA-Cerebral Vascular Accident
*If a person comes in and has hemiplegia I will code it as a last priority, if the hemiplegia is caused from a result of the main insult it will become more of a priority. --[[User:PStein|PStein]] 07:59, 1 February 2010 (CST)
* 50501 - CVA Post Angiogram
*Not all CVA's come in with [[Paraplegia, Hemiplegia]]. If it exists d/t CVA, I code it in.[[User:ENagy|ENagy]]
* 50502 - CVA Post OP
*I have been coding it the same as Gail .Shirley
* 50503 - CVA Post Trauma
*I code the CVA and Hemiparesis if present. This gives a more complete picture of the CVA. How do the doctors want it coded?--[[User:FLindell|FLindell]] 17:02, 3 February 2010 (CST)
* 50504 - CVA Post Anticoagulation TX (STK, TPA, TNK, HEP)
**I have always coded CVA and if they have resultant [[Paraplegia, Hemiplegia]], I code that as well. I thought this gives a more complete capture of the CVA. How the doctors want it coded?--FLindell 14:21, 1 February 2010 (CST)
* 50505 - CVA Intra OP
*I code the CVA and then code [[Paraplegia, Hemiplegia]] if it occurs with the stroke. Lois
* 50506 - CVA Post Partum
*I code the same as Lois both in the comorbids and admit diagnosis[[User:TAngell|TAngell]] 10:00, 3 February 2010 (CST)
* 50507 - CVA-Cerebral Venous Thrombosis
*I will code [[Paraplegia, Hemiplegia]] in co-mo's if they are existing. If the new dx. of cva also involves new hemi/paraplegia, I then code it in admits. If it is just a "weakness" associated with the new CVA, I do not code this as [[Paraplegia, Hemiplegia]].[[User:WGobert|gogogirl]] 10:11, 3 February 2010 (CST)
* 50508 - CVA-Brainstem
*I code CVA for admit then [[Paraplegia, Hemiplegia]] as [[:Category: | Comorbid | Comorbid]] along with CVA next admission. I thought (perhaps incorrectly) that [[ADL]] could be an indicator of weakness affecting the patient.--CMarks 17:49, 3 February 2010 (CST)
* 50590 - [[CVA 2nd to OTHER]]
| Yes | 1 | CC & Med | Currently Collected | | }}


=== No ===
[https://en.wikipedia.org/wiki/Stroke CVA (Cerebral Vascular Accident, Stroke)].
*I just code the CVA as this is the diagnosis.  I use the [[Paraplegia, Hemiplegia]] code only if these conditions exist for another reason that is not otherwise clear in the diagnosis. --[[User:LKolesar|LKolesar]] 08:57, 1 February 2010 (CST)
*I totally agree with LKolesar... I code the CVA as this IS the Dx.  I only use the [[Paraplegia, Hemiplegia]] codes in the como's if this is a pre-existing condition or DX if its secondary to another problem.--[[User:Wturner|Wturner]] 11:38, 1 February 2010 (CST)
*I have been coding similar to Laura. --[[User:MWaschuk|MWaschuk]] 15:13, 1 February 2010 (CST)
*I code the same way as Laura.   [[User:BDeVlaming|BDeVlaming]] 09:01, 2 February 2010 (CST)


A CVA can be due to ischemia caused by blockage ('''ARTERIAL''' thrombosis, '''ARTERIAL''' embolism), or a hemorrhage. Diagnostic imaging can identify the cause.


[[Category: Diagnosis Coding]]
See also Other [[Cerebral Infarct Cause NYD]]
[[Category: Neurological Problem]]
 
[[Category: Comorbid Diagnosis]]
== Coding Instructions ==
[[Category: Medical Problem]]
=== Don't code with [[Paraplegia, Hemiplegia]] ===
According to previous content of [[:Category:Paralysis (old)]] this code is not supposed to result in coding [[Paraplegia, Hemiplegia]]. ++Discussion++ what does that even mean? Ttenbergen 17:04, 2018 April 2 (CDT)
 
=== Co-code with TPA if applicable ===
Don't forget to code [[Thrombolytic Infusion (STROKE)]] if TPA actually administered to the patient in the ER prior to coming to your unit or while if given while in your unit.
 
=== Question: cause vs outcome ===
++Discussion++
* Are we concerned more with causes or diagnostic codes for CVA or the physiological outcome? Many CVAs have temporary weakness resolved post t Pa-versus dense hemi-paresis and as mentioned above diaphragmatic impacts-perhaps sub-coding is not so irrelevant when looking at patient rehab requirements or long-term care dispositions?--[[User:Llemoine|Llemoine]] 08:12, 2016 October 7 (CDT) 
** Are you asking about how you might change coding? I don't understand where you are going...  Ttenbergen 14:54, 2016 October 12 (CDT)
 
=== CVA secondary to '''Arterial''' blockage ===
*If a patient is coming in with a CVA secondary to an '''arterial blockage''' code as 50500 -CVA-Cerebral Vascular Accident. Do '''not code this as a venous CVA'''.
 
=== Incidental findings of '''OLD ''' lacunar infarcts ===
*Dan Roberts:Incidental findings of “'''old lacunar infarct'''” on CT will '''continue to be included''' as '''COMORBID diagnosis'''.  Staff have been including them as comorbids, if we stop including then this will affect the [[overstay]] project that is currently being piloted at the Grace and will eventually be done at other sites in the Region. -[[User:TOstryzniuk|Trish Ostryzniuk]] 10:52, 2012 September 14 (CDT)
 
== Legacy ==
Wording changed for 50507 to cerebral venous thrombosis to include all cerebral venous thrombosis. Discussed at the task meeting August 21,2014.
http://emedicine.medscape.com/article/1162804-overview
 
 
[[Category: Stroke (old)]]
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