Medical Coding Ejection Fraction Diagnosis

Medical Coding Ejection Fraction Diagnosis


Q: [Ejection Fraction] What is an ejection
fraction? Can I code an ejection fraction of 0% as with occlusion? A: Now, ejection fraction just happens to
be part of a cardiology aspect as well. You have ejection fractions for your gallbladder
but you also have ejection fraction as most commonly known for cardiology. It’s pretty
exciting. When I saw this question, I looked at and I thought, “OK, what is an ejection
fraction?” and first of all, I spelled it wrong when I was thinking of it, I spelled
it like injection, you give somebody an injection. But this is actually spelled with an “e”
and they’re saying, “Can I code an ejection fraction of 0% as with occlusion?” Well, let’s talk about what it is. By definition,
ejection fraction is a measurement of the percentage of blood leaving your heart each
time it contracts. So, picture your heart, you’ve got the two chambers at the top,
and you have the two chambers at the bottom. The two chambers at the bottom are called
ventricles. You have a right ventricle and a left ventricle. It just so happens that
the left ventricle is the one that has the most power, fills up with the most blood.
So, they can check both of them, but usually they start with the left ventricle. What happens is when that contracts, it pushes
out the blood, so then when it opens back up, the blood pushes into that ventricle.
You have a certain capacity that that ventricle, that chamber can hold; and as it contracts
and pushes that blood up pass the valve into the atrium, the ejection fraction is the amount
of blood that pushes that gets out of the chamber, but some of that blood is left in
the ventricle. So, let’s say that you’re never going to get 100% of the blood to go
up into the atrium, there will be a little bit left, so they take how much went up there,
let’s say, 85%; so then that’s how they measure that. It’s not what’s left in
the ventricle, it’s how much got pushed through. There are guidelines that tell you
how much is normal; so it’s measured. Since the left ventricle (LV) is the main
one that is the one measured. An LV ejection fraction of 55% or higher is for the most
part considered normal. That’s what you’re looking at. So, 55% of the blood goes from
the ventricle and whooshes up into the atrium, goes through that valve. If you’re 50% -55%,
it might be considered “borderline.” But there are some studies and different physicians
consider certain things 50, 51; 50 might not be borderline for them.