In a patient admitted with unstable angina and congestive heart failure, treated with nitrates and intravenous Lasix, what is the appropriate coding action?

• A. Assign the codes for unstable angina and congestive heart failure, sequence either first
• B. Code only unstable angina
• C. Code only congestive heart failure
• D. Do not code the cardiac conditions

Answer: (A)

When a patient is admitted with more than one significant condition that affects care, you code each condition that meets criteria and influences treatment. In this scenario, the patient has unstable angina and congestive heart failure, and both are actively treated (nitrates for angina, IV Lasix for CHF). Because both conditions are present and require management during that admission, both diagnoses should be coded. The principal diagnosis is the one that initiated the admission, but that does not prevent coding the other condition as well; the documentation or coding guidelines may determine which is listed first, and either order is acceptable as long as both are captured. Coding only one of the conditions would miss the care provided for the other, and coding neither would be inappropriate given the active cardiac issues addressed during the stay.