2025 ICD-10-CM code I48.0
Paroxysmal atrial fibrillation. This refers to sudden and episodic bouts of atrial fibrillation where symptoms come and go, usually lasting for a few minutes to hours, sometimes up to a week, and episodes can happen repeatedly.
The medical necessity for treating paroxysmal atrial fibrillation is based on the potential complications, such as stroke, heart failure, and reduced quality of life. Treatment is aimed at preventing these complications and managing the symptoms. Documentation should justify the chosen treatment approach, such as rate control, rhythm control, or anticoagulation, based on patient-specific factors and established guidelines.
Diagnosis and management of paroxysmal atrial fibrillation falls under the purview of cardiologists, electrophysiologists, internists, and family physicians, sometimes with the collaborative care of other specialists depending on the patient's overall health status. Accurate diagnosis involves reviewing the patient's medical history, physical examination, and electrocardiogram (ECG) findings during symptomatic episodes to capture the characteristic irregular heart rhythm. In some cases, ambulatory ECG monitoring (e.g., Holter monitor, event recorder) may be necessary to detect and document these intermittent episodes. Effective management requires an individualized approach based on factors such as the frequency and severity of episodes, patient symptoms, underlying medical conditions, and stroke risk stratification using tools like the CHA2DS2-VASc score. Treatment strategies may include rate control using beta-blockers or calcium channel blockers, rhythm control using antiarrhythmic drugs (e.g., amiodarone, flecainide), and anticoagulation therapy to prevent stroke in patients at high risk.
In simple words: Paroxysmal atrial fibrillation, also called paroxysmal AFib or occasionally AF, means you have bouts of an irregular heartbeat that come and go. These episodes can last for a few minutes, hours, or sometimes up to a week. During an episode, your heart might feel like it's fluttering or racing. While some people have no other symptoms, other possible effects are dizziness, tiredness, shortness of breath, and chest pain. Although the episodes stop on their own, they can recur.
Paroxysmal atrial fibrillation is a type of atrial fibrillation where the abnormal heart rhythm is intermittent.The episodes of irregular heartbeat start suddenly and spontaneously, and typically last for a few minutes to hours.In some cases, episodes may persist for as long as a week.These episodes can recur multiple times.This distinguishes it from other types of atrial fibrillation, such as persistent, long-standing persistent, and permanent AFib, where the irregular heart rhythm is continuous.
Example 1: A 65-year-old patient presents with sudden-onset palpitations, shortness of breath, and lightheadedness. An ECG reveals atrial fibrillation. The symptoms resolve spontaneously within two hours. The patient reports similar episodes in the past, each lasting a few hours. This presentation is consistent with paroxysmal atrial fibrillation (I48.0)., A 50-year-old patient experiences intermittent episodes of rapid, irregular heartbeat lasting for several minutes, accompanied by chest discomfort. These episodes have been occurring for the past few months, with symptom-free periods in between.A Holter monitor confirms the diagnosis of paroxysmal atrial fibrillation (I48.0)., A 70-year-old patient with hypertension presents for a routine check-up.They report occasional episodes of heart fluttering and lightheadedness that resolve on their own.An ECG performed during one of these episodes reveals atrial fibrillation. The patient is diagnosed with paroxysmal atrial fibrillation (I48.0).
Documentation for I48.0 should include a clear description of the episodes, including the frequency, duration, associated symptoms, and ECG findings confirming atrial fibrillation during an episode.If ambulatory monitoring is used, the report should be included. Any other relevant medical history, such as hypertension or heart disease, should also be noted.
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