CVA-Cerebral Vascular Accident

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This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Cerebral infarction/stroke, NOS, Cerebral infarction/stroke due to embolism, Hemorrhage, intracerebral/intracranial, nontraumatic (ICH, hemorrhagic stroke), Stroke, NOS, Subdural or epidural hematoma/hemorrhage, nontraumatic, Hemorrhage, subarachnoid or ruptured cerebral aneurysm

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Category/Organ System:	Category: Neurological Problem (old)
Type:	[[:Category: Medical Problem (old)]][[Category: Medical Problem (old)]]
Main Diagnosis:	CVA-Cerebral Vascular Accident
Sub Diagnosis:	Yes
Diagnosis Code:	50500 -CVA-Cerebral Vascular Accident 50501 - CVA Post Angiogram 50502 - CVA Post OP 50503 - CVA Post Trauma 50504 - CVA Post Anticoagulation TX (STK, TPA, TNK, HEP) 50505 - CVA Intra OP 50506 - CVA Post Partum 50507 - CVA-Superior Sagital Sinus 50508 - CVA-Brainstem 50590 - CVA 2nd to OTHER Procedure
Comorbid Diagnosis:	Yes see: Comorbid Diagnosis
Charlson Comorbid coding (pre ICD10):	1
Program:	CC & Med
Status:	Currently Collected

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.

• also see Other Cerebral Infarct Cause NYD

This can be due to ischemia caused by blockage (thrombosis, arterial embolism), or a hemorrhage. Diagnostic imaging can identify the cause.

• We do not code paralysis or Paraplegia, Hemiplegia with the CVA.
  • Template:Discussion Is Diaphragmatic Paralysis the Dx you are telling not to code? If not, which dx is it? This instruction should be at that article as well, since that might be where someone looks first to find out whether to code it. Ttenbergen 09:44, 2012 September 13 (CDT)Ttenbergen

• if admitted with a acute stroke, the DX stays as part of the admitting DX until patient is discharged from the hospital system in the Region. It will be coded as a comorbid on the next new admission to a hospital system in the Region. This is in following the same rule as for when does an ARF become CRF. --TOstryzniuk 19:48, 2 December 2010 (CST)
  • does that rule only apply to these two dxs, or to all? Ttenbergen 11:04, 2013 January 21 (EST) Template:Discussion

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. -Trish Ostryzniuk 10:52, 2012 September 14 (CDT)

eliminate code?

• 50508 - CVA-Brainstem is really the same as code 504. This was an unintended double code that crept into list ages ago.Trish Ostryzniuk 16:05, 2012 July 12 (CDT)
  • Template:Discussion should we delete one of them from the drop-down? if so, please add to Requested CCMDB changes for the next versionTtenbergen 09:37, 2012 September 13 (CDT)Ttenbergen

Sept 14.12 Survey

QUESTION: OLD lacunar infarcts Where do you code incidental find of from CT: OLD lacunar infarct

• VIC ICU & Med – 2/2 staff replied
  • Comorbid DX

• CON ICU – 1/1 staff replied
  • Comorbid DX

• STB ICU & Med – 2 staff out of 5 replied - 3 awaiting reply
  • Comorbid DX
    • waiting for reply from: Debbie, Laura (vacation), Marla.-Trish Ostryzniuk (talk) 18:29, 2012 September 17 (CDT)

• HSC ICU & Med – 3 of 6 staff replied – 3 awaiting reply
  • Comorbid DX – only in admit if it is a new CVA
  • waiting for reply from: Joyce,Fran, Pat.-Trish Ostryzniuk (talk) 18:29, 2012 September 17 (CDT)

• OAK ICU – 1/1 staff replied
  • Comorbid DX

• GRA ICU & Med – 3/3 staff replied
  • Comorbid DX unless DX as acute, then in admit

• What is the outcome of this survey, i.e where should things be coded? Ttenbergen 11:04, 2013 January 21 (EST) Template:Discussion