Myocardial infarction: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
← Older edit
TOstryzniuk (talk | contribs)
CCMDB_legit, approved, Bureaucrats, Administrators
27,522 edits
mNo edit summary
m Text replacement - "[[Category: " to "[[Category:"
 
(54 intermediate revisions by 7 users not shown)
Line 1: Line 1:
{{DX tag | [[:Category: Cardiovascular Problems | Cardiovascular Problem]] | [[:Category: Medical Problem | Medical Problem]]| [[:Category: Myocardial infarction | Myocardial infarction]] | Yes - see [[:Category: Myocardial infarction | Myocardial infarction]] |
{{PreICD10 dx| NewDxArticle = Myocardial infarction, acute (AMI), NOS}}
*01.  [[ANTERIOR MI]]
{{PreICD10 dx| NewDxArticle = Myocardial infarction (STEMI), acute (AMI), transmural (Q-wave)}}
*02.  [[ANTEROSEPTAL MI]]
{{PreICD10 dx| NewDxArticle = Myocardial infarction (NSTEMI), acute (AMI), subendocardial/non-transmural (non-Q-wave)}}
*03.  [[LATERAL MI]]
 
*04.  [[INFERIOR MI]]
{{DX tag | Cardiovascular Problems | Medical Problem| Myocardial infarction |  | Myocardial infarction |  
*05.  [[POSTERIOR MI]]
*10200 - Myocardial Infarction
*06.  [[RIGHT VENTRICULAR MI]]
*10201 - Myocardial Infarction - Anterior
*07.  [[NON TRANSMURAL (NON Q)MI]]
*10201 - Myocardial Infarction - Anteroseptal
*08.  [[INTRA-OPERATIVE MI]]
*10203 - Myocardial Infarction - Lateral
*09.  [[POST-OPERATIVE MI]]
*10204 - Myocardial Infarction - Inferior
*10.  [[MI ABORTED WITH TPA]] | 102-xx | '''Critical Care and Medicine''' | Currently Collected | | ||}}
*10205 - Myocardial Infarction - Posterior
*10206 - Myocardial Infarction - Right Ventricle
*10207 - Myocardial Infarction - Non Transmural (non Q)
*10208 - Myocardial Infarction - Intraoperative
*10209 - Myocardial Infarction - Postoperative
'''Item below not allowed in comorbid
*'''10210 - Myocardial Infarction aborted with TPA
| Yes  | 1 |CC & Med | | | ||}}
 
In CCI/ICD10 this will be coded by coding the MI as an ICD10 dx, and then [[Pharmacotherapy, thrombolytic agent]] with the [[CCI component 1 codes - what organ was something done to]].


== Criteria==
== Criteria==
*Documented CPK rise or classic EKG changes
*Documented CPK rise or classic EKG changes


**See [[ICU Var 2]] to tag MI Care Map [[MAP]].
== MI Coding instructions ==
MIs are occasionally listed as "Type 2 MIs", ie no evidence of coronary artery disease(CAD). This refers to the mechanism, and we don't care about the mechanism. They should be coded based on their manifestation.  


{{Discussion}}
For ICD 10 instructions for this, see [[Template:ICD10 Guideline MI type vs mechanism]]
== Discussion ==
* The subdiagnoses are not mutually exclusive, an MI could be both post-op and anterior. What is the precedence with which to collect these? Even if we explain this here, there still is a risk of misunderstanding. I think the ones that are not exclusive shoudl be eliminated. (The same is probably true for other dxs) [[User:Ttenbergen|Ttenbergen]] 12:51, 18 February 2009 (CST)
** On second thought, would we just code both post-op and anterior, leading to two MI dxs? If so, which goes first, since we report on primary admit DXs? Also, does this lead to higher numbers of MI reported? If a patient in fact has two MIs, one post-op with location unknown, and one anterior when first admitted, would our db report this as just one MI or as several? I will send this to Julie as well.[[User:Ttenbergen|Ttenbergen]] 12:56, 18 February 2009 (CST)
***Good point Tina because we only list 6 dx, how do we priortize if the MI is both post-op and anterior if we do not have room on our dx list?  Which is more NB to know, the MI being post-op or the location of the MI?--[[User:MWaschuk|MWaschuk]] 13:49, 18 February 2009 (CST)
*** I agree with you as well.Is the criteria for post-op defined by a time line e.g. 48 hours or less,or is there a definite criteria?--[[User:JKothuber]]


==Data Integrity Rules==
In the old coding schema, this means:
* ++discussion++ I have no idea what it means in the old schema; I just needed to break out Allan's answer. Chances are similar things apply in the old schema. Leaving the discussion trail in here for now for this.
*I have seen quite a few type 2 MI's and our database really does not deal with this.  A type 2 MI is when there is no evidence of coronary artery disease, but the MI still occurs for other reasons.  It occurs when there is  supply/demand mismatch with no CAD.  The most common one we see is related to prolonged anemia where the pt's oxygen-carrying capacity is reduced.  Another reason would be reduced blood volume (hypovolemia), profound bradycardia, etc.  These conditions can cause an MI even with normal coronary arteries. 
* I propose that if there is a supply/demand mismatch with normal coronaries and there is an elevated troponin, we call in a non Q MI (NSTEMI)unless there is a clear diagnosis of a STEMI or other reason for an increased troponin.  The other option is to make a new category for type 2 MI.--[[User:LKolesar|LKolesar]] 14:38, 2015 November 16 (CST)
* I don't think this is new...we recognize this in the ACS population...if angio isn't done coronary arteries/status would not be known but we still code as NSTEMI (reviewing the EKGs and cardiology consult notes) and have been for awhile.--[[User:Llemoine|Llemoine]] 14:47, 2015 November 16 (CST)


*If 102-10 you must not use any another 102 with a subcode.
*This rule is not yet implemented in ACCESS.


*See [[ICU Var 2]] to tag MI Care Map [[MAP]] {{discussion}}
** MAP isn't being checked anywhere because there is no cross-check if it is not true but just forgotten. If one should be made, we would need to actively track XMAP if someone is not getting MAP. Since we track [[BRR]] in the same field this would not be doable. Could move one of the two into the tmp fields. Maybe the bigger question is: should we collect this forever? Let's report on it, ask if they plan to do anything about it, and offer to collect again after. [[User:Ttenbergen|Ttenbergen]] 00:37, 5 May 2009 (CDT)


[[Category: Myocardial infarction]]
[[Category:ACS (old)]]
[[Category: Data Integrity Rules]]
[[Category: Questions Diagnosis]]

Latest revision as of 10:56, 30 July 2025



Legacy Content

This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:Myocardial infarction, acute (AMI), NOS, Myocardial infarction (STEMI), acute (AMI), transmural (Q-wave), Myocardial infarction (NSTEMI), acute (AMI), subendocardial/non-transmural (non-Q-wave)

Click Expand to show legacy content.


edit dx infobox
Category/Organ
System: 		Category: Cardiovascular Problems (old)

Type:

Category: Medical Problem (old)

Main Diagnosis: Myocardial infarction
Sub Diagnosis:
Diagnosis Code: Myocardial infarction
Comorbid Diagnosis:
  • 10200 - Myocardial Infarction
  • 10201 - Myocardial Infarction - Anterior
  • 10201 - Myocardial Infarction - Anteroseptal
  • 10203 - Myocardial Infarction - Lateral
  • 10204 - Myocardial Infarction - Inferior
  • 10205 - Myocardial Infarction - Posterior
  • 10206 - Myocardial Infarction - Right Ventricle
  • 10207 - Myocardial Infarction - Non Transmural (non Q)
  • 10208 - Myocardial Infarction - Intraoperative
  • 10209 - Myocardial Infarction - Postoperative

Item below not allowed in comorbid

  • 10210 - Myocardial Infarction aborted with TPA
Charlson Comorbid coding (pre ICD10): Yes
Program: 1
Status: CC & Med


In CCI/ICD10 this will be coded by coding the MI as an ICD10 dx, and then Pharmacotherapy, thrombolytic agent with the CCI component 1 codes - what organ was something done to.

Criteria

  • Documented CPK rise or classic EKG changes

MI Coding instructions

MIs are occasionally listed as "Type 2 MIs", ie no evidence of coronary artery disease(CAD). This refers to the mechanism, and we don't care about the mechanism. They should be coded based on their manifestation.

For ICD 10 instructions for this, see Template:ICD10 Guideline MI type vs mechanism

In the old coding schema, this means:

  • ++discussion++ I have no idea what it means in the old schema; I just needed to break out Allan's answer. Chances are similar things apply in the old schema. Leaving the discussion trail in here for now for this.
  • I have seen quite a few type 2 MI's and our database really does not deal with this. A type 2 MI is when there is no evidence of coronary artery disease, but the MI still occurs for other reasons. It occurs when there is supply/demand mismatch with no CAD. The most common one we see is related to prolonged anemia where the pt's oxygen-carrying capacity is reduced. Another reason would be reduced blood volume (hypovolemia), profound bradycardia, etc. These conditions can cause an MI even with normal coronary arteries.
  • I propose that if there is a supply/demand mismatch with normal coronaries and there is an elevated troponin, we call in a non Q MI (NSTEMI)unless there is a clear diagnosis of a STEMI or other reason for an increased troponin. The other option is to make a new category for type 2 MI.--LKolesar 14:38, 2015 November 16 (CST)
  • I don't think this is new...we recognize this in the ACS population...if angio isn't done coronary arteries/status would not be known but we still code as NSTEMI (reviewing the EKGs and cardiology consult notes) and have been for awhile.--Llemoine 14:47, 2015 November 16 (CST)
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Myocardial_infarction&oldid=166624"