Q&A: Is CHF always an ongoing condition or can be a past condition?

Q: I often find congestive heart failure (CHF) listed under past medical history. Frequently, the patient also has hypertension (HTN) and coronary artery disease (CAD), so they’re on medications. When I query for the type of CHF, the providers sometime document “no CHF.” I’ve heard before, though, that CHF is an ongoing diagnosis like chronic obstructive pulmonary disease (COPD). I’m very confused because more than once a provider has said to me that the CHF is in their history and not a current diagnosis. Is this possible or is CHF always an ongoing condition?

A: I think there are a few things here that we need to address. First, CHF is generally a progressive disease where a patient can have periods of stability followed by periods of decompensation. It’s a disease process where patients can vary quite a bit. CHF comes from blood backing up and into the lungs, liver, abdomen, or lower extremities.

I think some of the confusion may come from the fact that not all heart failures (HF) are congestive. This is why we see a lot of physicians now using the term HF instead of CHF and why they might be responding to your queries that there is no CHF or that it may only be in the patients’ past medical history.

When you query the physicians, it may be helpful to give them the clinical indicators that you have found within the medical record, including medications and/or treatments. Then, ask based on these clinical indicators what they’re treating.

Editor’s Note: Sharme Brodie RN, CCDS, CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts, answered this question. For information, contact her at sbrodie@hcpro.com. For information regarding CDI Boot Camps offered by HCPro, visit www.hcprobootcamps.com/courses/10040/overview.