Welcome to the Impact Registry's February case scenario. This case scenario will review Sequence 3222, Heart Failure. Our documentation involves a 40-year-old female with a history of transposition of the great arteries, who presents to her physician's office with complaints of shortness of breath, cough, intermittent chest pain, and fatigue when performing her routine daily activities. The physician obtains an ECG, which shows a new-onset arrhythmia and prompts the physician to send the patient as a direct admin to your hospital for further evaluation. For the patient's H&P, her admitting diagnosis is NYHA Class 2 and new-onset cardiac arrhythmia. Our question is, how is Sequence 3222, Heart Failure, within one month coded in this scenario? Is it 1, No, or 2, Yes? The answer is 2, Yes. The target value of Sequence 3222 is any occurrence between one month prior to arrival and arrival. The patient was diagnosed with NYHA Class 2 Heart Failure prior to admission, therefore the target value is met. When there is no diagnosis of heart failure documented by the physician, but an NYHA class is provided, Yes is coded for Sequence 3222, Heart Failure. This is supported by the child field Sequence 3223, NYHA Functional Classification. Additionally, the NYHA classification is used specifically to classify a patient's heart failure according to severity of their symptoms and may be used in Sequence 3222 for coding purposes. When Yes is coded in Sequence 3222, the child field Sequence 3223 opens up for coding. In this specific scenario, Sequence 3223 is coded Class 2. This concludes the February Monthly Case Scenario. We thank you for your participation.

transposition of the great arteries

arrhythmia

NYHA Class 2 Heart Failure

coding requirements

ECG