ICH 2nd to other causes

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Category/Organ System:	Category: Neurological Problem (old)
Type:	Category: Medical Problem (old)
Main Diagnosis:	Intracerebral hemorrhage
Sub Diagnosis:	ICH 2nd to other cuases
Diagnosis Code:	50290 - ICH 2nd to other causes
Comorbid Diagnosis:	No
Charlson Comorbid coding (pre ICD10):	0
Program:	CC & Med
Status:	Currently Collected

ICH - Intra-cerebral hemorrage /intracerebral hemorrage

coding 50290 with a subcode 90 is the same as coding 50200 without a subcode. (other cause or unknown cause.

AG REPLY -- There is no single ICD10 code for hemorrhagic transformation of in initially ischemic stroke. Instead, what should be done is: Code both the ischemic stroke (either as Cerebral infarction/stroke due to embolism or Cerebral infarction/stroke, NOS AND combine that code with the appropriate code for the nontraumatic intracerebral hemorrhage.

If you have a patient who has had a CVA, who on a follow up CT has "hemorrhagic transformation", would you use this code? The hemorrhage didn't appear to cause symptoms, however ASA was held as a result. Would this even warrant coding?Mlagadi 15:32, 2017 April 11 (CDT)
- AG REPLY -- this current article is not an ICD10 code. There is no single ICD10 code for hemorrhagic transformation of in initially ischemic stroke. Instead, what should be done is: Code both the ischemic stroke (either as Cerebral infarction/stroke due to embolism or Cerebral infarction/stroke, NOS AND combine that code with the appropriate code for the nontraumatic intracerebral hemorrhage.

- We see these results not uncommonly in H4H at HSC post tPa in thrombic CVas-my premise has been if there are changes in their GCS and/or cerebral edema requiring intervention then I code as a comp related to anticoagulation (Complication of anticoagulation therapy) otherwise I do not capture-the neuro notes are usually pretty clear regarding the follow-up CTs done where these occur.--Llemoine 08:00, 2017 April 13 (CDT)
  - AG REPLY --- if the hemorrhage after an ischemic stroke was NOT spontaneous, but followed anticoagulation, then indeed the hemorrhage should be coded as Hemorrhage, due to anticoagulant drugs since it's not a spontaneous hemorrhagic transformation, and thus is a complication of treatment, not a complication of the stroke per se.