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 |
Strokes
* [[50500 -CVA-Cerebral Vascular Accident]]
{{PreICD10 dx | NewDxArticle = Cerebral infarction/stroke due to embolism}}
* [[50501 - CVA Post Angiogram]]
{{PreICD10 dx | NewDxArticle = Cerebral infarction/stroke, NOS}}
* [[50502 - CVA Post OP]]
{{PreICD10 dx | NewDxArticle = Stroke, NOS}}
* [[50503 - CVA Post Trauma]]
{{PreICD10 dx | NewDxArticle = Subdural or epidural hematoma/hemorrhage, nontraumatic}}
* [[50504 - CVA Post Anticoagulation TX (STK, TPA, TNK, HEP)]]
{{PreICD10 dx | NewDxArticle = Hemorrhage, intracerebral/intracranial, nontraumatic (ICH, hemorrhagic stroke)}}
* [[50505 - CVA Intra OP]]
{{PreICD10 dx | NewDxArticle = Hemorrhage, subarachnoid or ruptured cerebral aneurysm}}  
* [[50506 - CVA Post Partum]]
* [[50507 - CVA-Cerebral Venous Thrombosis]]
* [[50508 - CVA-Brainstem]]
* 50590 - [[CVA 2nd to OTHER Procedure]]
| Yes see: [[:Category: Comorbid Diagnosis | Comorbid Diagnosis]] | 1 | CC & Med | 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.
{{DX tag | Neurological Problem | Medical Problem | CVA-Cerebral Vascular Accident | Yes |
* 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-Cerebral Venous Thrombosis
* 50508 - CVA-Brainstem
* 50590 - [[CVA 2nd to OTHER]]
| Yes | 1 | CC & Med | Currently Collected |  | }}


* We do not code  paralysis or [[Paraplegia, Hemiplegia]] with the CVA.
[https://en.wikipedia.org/wiki/Stroke CVA (Cerebral Vascular Accident, Stroke)].
** {{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. [[User:Ttenbergen|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. --[[User:TOstryzniuk|TOstryzniuk]] 19:48, 2 December 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.
** does that rule only apply to these two dxs, or to all? Ttenbergen 11:04, 2013 January 21 (EST) {{discussion}}


== Question: CVA secondary to arterial blockage ==
See also Other [[Cerebral Infarct Cause NYD]]
{{Discussion}}
*If a patient is coming in with a CVA secondary to an arterial blockage, is this how we are supposed to code it? None of the other sub diagnoses seem to apply. Does anyone use the subcode "secondary to central venous thrombosis" for an embolic arterial blockage?[[User:Mlagadi|Mlagadi]] 14:34, 2016 September 27 (CDT)
**I have seen this type of stroke in some very neuro specific cases where it is documented as specifically a venous thrombus stroke.  I have seen at least 2 this year.--[[User:Jpeterson|Jpeterson]] 11:07, 2016 September 28 (CDT)
*** How did you code them, Joyce? Ttenbergen 09:26, 2016 September 29 (CDT)
**I have also seen several but they are always labelled as due to thrombosis rather than obstruction [[User:SCortilet|SCortilet]] 10:32, 2016 September 30 (CDT)


== Incidental findings of '''OLD ''' lacunar infarcts ==
== Coding Instructions ==
*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)
=== 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)


== eliminate code? ==
=== Co-code with TPA if applicable ===
* ''50508 - CVA-Brainstem'' is really the same as code 504. This was an unintended double code that crept into list ages ago.[[User:TOstryzniuk|Trish Ostryzniuk]] 16:05, 2012 July 12 (CDT)
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.
** {{discussion}} should we delete one of them from the drop-down? if so, please add to [[Requested CCMDB changes for the next version]][[User:Ttenbergen|Ttenbergen]] 09:37, 2012 September 13 (CDT)Ttenbergen


===Sept 14.12 Survey===
=== Question: cause vs outcome ===
QUESTION:
++Discussion++
OLD lacunar infarcts
* 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)  
Where do you code incidental find of from CT: OLD lacunar infarct
** Are you asking about how you might change coding? I don't understand where you are going...  Ttenbergen 14:54, 2016 October 12 (CDT)


*VIC ICU & Med – 2/2 staff replied
=== CVA secondary to '''Arterial''' blockage ===
**Comorbid DX
*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'''.


*CON ICU – 1/1 staff replied
=== Incidental findings of '''OLD ''' lacunar infarcts ===
**Comorbid DX
*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)
 
*STB ICU & Med – 2 staff out of 5 replied - 3 awaiting reply
**Comorbid DX
*** waiting for reply from: Debbie, Laura (vacation), Marla.-[[User:TOstryzniuk|Trish Ostryzniuk]] ([[User talk:TOstryzniuk|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.-[[User:TOstryzniuk|Trish Ostryzniuk]] ([[User talk:TOstryzniuk|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) {{discussion}}


== Legacy ==
== Legacy ==
Line 69: Line 50:




[[Category: Stroke]]
[[Category: Stroke (old)]]
[[Category:Charlson Comorbid Diagnosis]]
[[Category:Charlson - Cerebrovascular Disease]]

Latest revision as of 16:06, 2019 January 3

Strokes





Legacy Content

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

Click Expand to show legacy content.


edit dx infobox
Category/Organ
System: 		Category: Neurological Problem (old)

Type:

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-Cerebral Venous Thrombosis
  • 50508 - CVA-Brainstem
  • 50590 - CVA 2nd to OTHER
Comorbid Diagnosis: Yes
Charlson Comorbid coding (pre ICD10): 1
Program: CC & Med
Status: Currently Collected


CVA (Cerebral Vascular Accident, Stroke).

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

See also Other Cerebral Infarct Cause NYD

Coding Instructions

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?--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. -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

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