Unstable angina

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This page is about the pre-ICD10 diagnosis coding schema. See the ICD10 Diagnosis List, or the following for similar diagnoses in ICD10:

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Category/Organ System:	Category: Unstable angina (old)
Type:
Main Diagnosis:	151-00
Sub Diagnosis:	Critical Care and Medicine
Diagnosis Code:	Currently Collected
Comorbid Diagnosis:	May 27.2004
Charlson Comorbid coding (pre ICD10):
Program:
Status:

151 UNSTABLE ANGINA PAIN < 15 MIN. RELIEVED BY NITRO OR @ REST

Discussion

• I think unstable angina and coronary insuffiency have incorrect descriptions in our code book. Unstable angina is angina that is "UNSTABLE" it occurs at rest often lasts more than 15 minutes and needs more aggressive interventions with nitro spray,oxygen,IV morphine. Coronary insufficiency lasts less than 15 minutes and is managed well with nitrospray and rest.The most comman thing we see with the charts is the term "ACS" which emcompasses unstable angina,NSTEMI and STEMI.I would like to know how other collectors are coding patients with cardiac chest pain?GHall 11:56, 2 March 2009 (CST)

• • I agree with you that the wording or classifications are used differently now. At the VIC if it is not clearly an STEMI or a NSTEMI we use Acute Coronary Insufficiency. If they have a history of chest pain that is not described as Unstable angina, we use 152 - Chronic stable angina. I would like us to be to use the classification ACS (unless it is clearly an NSTEMI) JWinestock 17:06, 3 March 2009 (CST)JWinestock
  • I collect on Medicine A4. When patient's are admitted with chest pain, the physician's will document Unstable Angina, ACS, or r/o ACS. This does pose a problem for data collecors who are not cardiologists. The history and physical assessement will contain information about the chest pain, and usually the chest pain lasts less than 15 min, or relieved by rest and the physican's will call this USA or ACS pending diagnotics like MUGA, Coronary angio, stress tests etc... I try to follow what the book states, and I have not entered the code corresponding to coronary insufficiency often. To clarify the A4 physician's like to use unstable angina or ACS.--JHutton 09:07, 5 March 2009 (CST)
  • Please Trish, clarify if there is a problem with under reporting Coronary insufficiency, is there a major difference in coding convention that would skew data in the data base between the two codes in question??--JHutton 09:07, 5 March 2009 (CST)

• • • Could we add this to the meeting agenda?NMiller 15:02, 4 March 2009 (CST)NMiller