Myocardial infarction: Difference between revisions
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{{DX tag | Cardiovascular | {{PreICD10 dx| NewDxArticle = Myocardial infarction, acute (AMI), NOS}} | ||
{{PreICD10 dx| NewDxArticle = Myocardial infarction (STEMI), acute (AMI), transmural (Q-wave)}} | |||
* | {{PreICD10 dx| NewDxArticle = Myocardial infarction (NSTEMI), acute (AMI), subendocardial/non-transmural (non-Q-wave)}} | ||
* | |||
* | {{DX tag | Cardiovascular Problems | Medical Problem| Myocardial infarction | | Myocardial infarction | | ||
* | *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) | ||
| Yes | 1 |CC & Med | | *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 | ||
== | == 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.--[[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) | |||
[[Category: | [[Category:ACS (old)]] | ||
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: |
|
| Main Diagnosis: | Myocardial infarction |
| Sub Diagnosis: | |
| Diagnosis Code: | Myocardial infarction |
| Comorbid Diagnosis: |
Item below not allowed in comorbid
|
| 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)