After careful study, it is our belief that ALL complex congenital heart conditions should be coded with every patient admission/encounter. These conditions should be considered as “active” problems rather than as a patient’s resolved history. As such, they should be coded as either primary or secondary diagnoses, depending on the reason for admission. Whether or not the surgery was palliative or part of a staged surgical plan is irrelevant, and these codes should be used for these patients for a lifetime. These issues repaired or not, have real bearing on a patient’s risk because they require:

1. Clinical Evaluation - These patients may have Cardiology notified or consulted while admitted and have regularly scheduled visits with Cardiology for many years after surgery.

2. Therapeutic Treatment - These patients are frequently on home medications that need to be continued while inpatient for years after surgery, or even for life.

3. Diagnostic Procedures - Additional studies such as echocardiograms, electrocardiograms (EKGs), and telemetry are frequently needed during admission.

4. Extended Length of Hospital Stay - Patients with underlying congenital heart conditions frequently require an extended hospitalization period.

5. Increased Nursing Care and/or Monitoring - When these patients are admitted, they often require higher level care (frequently IMC), where they receive lower nurse-to-patient ratio and continuous cardiopulmonary monitoring.