2025 ICD-10-CM code I48.21
(Active) Effective Date: N/A Diseases of the circulatory system - Other forms of heart disease I00-I99 Feed
Permanent atrial fibrillation.
Medical necessity for the management of permanent atrial fibrillation is established by the presence of the condition and the need for ongoing treatment, typically focused on rate control and stroke prevention.
Physicians who diagnose and manage atrial fibrillation, including cardiologists, electrophysiologists, and general practitioners, are responsible for accurately documenting the type and duration of the arrhythmia, any associated symptoms, prior treatment strategies, and the rationale for designating the atrial fibrillation as permanent. This documentation supports the use of I48.21.
In simple words: Permanent atrial fibrillation means the heart beats irregularly and fast in the upper chambers and this rhythm is persistent and won't be changed back to a normal rhythm.
Permanent atrial fibrillation is a condition characterized by a persistent irregular and rapid heart rate originating in the atria.This rhythm persists despite attempts or the decision to forego cardioversion back to a normal sinus rhythm.
Example 1: A 75-year-old patient with a history of hypertension and coronary artery disease presents with persistent atrial fibrillation that has been ongoing for several months. Despite two attempts at cardioversion, the patient remains in atrial fibrillation. The cardiologist decides that further cardioversion attempts are not indicated, and the patient's atrial fibrillation is documented as permanent., A 60-year-old patient with long-standing persistent atrial fibrillation is evaluated for cardioversion. Due to concerns about potential complications and the patient's overall health status, the patient and physician agree that cardioversion will not be pursued. The atrial fibrillation is documented as permanent., A 50-year-old patient with persistent atrial fibrillation declines cardioversion, preferring rate control management. The physician documents the atrial fibrillation as permanent, reflecting the patient's decision to not pursue rhythm control.
Documentation should clearly state the type of atrial fibrillation as "permanent," indicating that it is ongoing and that cardioversion has either failed or is not planned.The duration of the arrhythmia should be noted, along with any associated symptoms and comorbidities.The decision-making process regarding cardioversion, including why it was unsuccessful or not pursued, should also be documented.
- Payment Status: Active
- Specialties:Cardiology, Electrophysiology, Internal Medicine, Family Medicine
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home