Longstanding persistent atrial fibrillation

This code signifies a chronic form of atrial fibrillation where the arrhythmia has been continuous for more than 12 months, or for less than 12 months but a decision has been made not to restore or maintain sinus rhythm. It indicates a sustained, unremitting atrial tachyarrhythmia.

Apply this code when documentation explicitly states "longstanding persistent atrial fibrillation" or "chronic persistent atrial fibrillation" lasting over one year, or when a persistent AFib is deemed permanent by the physician. It is appropriate when cardioversion has failed or is not indicated, and rate control is the primary management strategy.

• Differentiate from "persistent atrial fibrillation" (I48.19), which has a shorter duration or no specified duration.
• Ensure physician documentation clearly specifies "longstanding" or a duration exceeding 12 months for persistent AFib.
• This code is typically a primary diagnosis or a significant secondary diagnosis impacting patient management.