Q&A: When is it appropriate to report code for asystole?

April 26, 2011

QUESTION: We have a patient who has sick sinus syndrome, and the physician ultimately needed to insert a pacer. Physician documentation stated that the patient also had a “15–20 second episode of asystole that resolved.” Other notes in the record refer to this as a 15–20 second pause and also cardiac arrest.

According to Uniform Hospital Discharge Data Set guidelines, you may code asystole even when the provider does not perform CPR. One of our cardiologists said that if they don't have to resuscitate the patient, it's not truly asystole but rather a sinus pause (for which we would report a different code). After explaining the guidelines to the cardiologist, I asked, “If the physicians document asystole or cardiac arrest, do you agree that it should be coded?” He said yes, but reiterated that unless the physician performs CPR, he doesn't feel it's truly asystole. We’re wondering how to handle these kinds of scenarios.

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