Permanent atrial fibrillation

This code signifies a chronic, sustained atrial arrhythmia characterized by disorganized electrical activity in the atria, leading to an irregular and often rapid ventricular response. It represents atrial fibrillation that is refractory to cardioversion or for which cardioversion has not been attempted or is contraindicated, and is considered a long-term, ongoing condition.

Assign this code when documentation clearly indicates atrial fibrillation that is explicitly stated as "permanent," "chronic," or "long-standing" and not expected to convert to sinus rhythm. This applies to patients who have failed attempts at rhythm control, are not candidates for cardioversion, or for whom a decision has been made to pursue rate control strategies indefinitely.

• Differentiate from other forms of atrial fibrillation (e.g., paroxysmal, persistent) based on physician documentation regarding duration and treatment intent.
• Do not use this code if the atrial fibrillation is described as "persistent" but with ongoing attempts or plans for cardioversion.
• Always review the entire medical record to confirm the permanent nature of the atrial fibrillation, especially if only "chronic" is documented.