Time is a critical factor when treating stroke and returning the patient to his/her neurological baseline. The BEFAST mnemonic (Balance, Eyes Face, Arm, Speech, Time) is a useful tool to help quickly identify stroke symptoms and know when to seek emergent medical care.
And while we can all agree that treating the patient is the most important factor, for coding and clinical documentation improvement (CDI) professionals, the challenge comes when it’s time to code the encounter. Code assignment is based on various factors including the underlying cause of the stroke (hemorrhage vs. infarction) and the specific artery affected (cerebral vs. precerebral), including laterality. For hemorrhagic stroke, whether the bleed was caused by traumatic or nontraumatic means as well as the specific location of the bleed (intracerebral vs. subdural) are determining factors in code assignment. And for cerebral infarction, the cause of the infarction (embolism, thrombosis, or occlusion/stenosis) is a critical code element.
How do you sort all this out and remember the depth of specificity for these codes? I present to you the BEFAST Mnemonic for Coding and CDI Professionals:
- B Is the patient experiencing a hemorrhagic stroke? Or
- E Is the patient experiencing an infarction caused by embolism, thrombosis, stenosis or occlusion?
- F If the patient is having a hemorrhagic stroke, what is the focal area of the bleed?
- A What is the specific artery affected?
- S Which side of the brain is affected?
- T For hemorrhagic stroke, was it caused by trauma?
If you want to learn more about stroke coding, including the different types of strokes, how to dig for documentation necessary for specific code assignment, and to walk through some case studies, be sure to join us for the webinar ICD-10-CM Stroke Coding: The Why Behind the Codes.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Director of Coding Quality & Education
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
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