Unstable angina: Difference between revisions

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==Discussion==
==Discussion==
 
*At our most recent meeting on April 8,2009 Trish said if the doctors are calling the cardiac chest pain "unstable angina" code it that way. If they are calling the cardiac chest pain coronary insufficiency then code it that way.She mentioned taking away the definitions in the code book.
{{Discussion}}
{{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 common thing we see with the charts is the term "ACS" which encompasses unstable angina, NSTEMI and STEMI.  I would like to know how other collectors are coding patients with cardiac chest pain?--[[User:GHall|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) [[User:JWinestock|JWinestock]] 17:06, 3 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) [[User:JWinestock|JWinestock]] 17:06, 3 March 2009 (CST)
 
***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.--[[User:JHutton|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??--[[User:JHutton|JHutton]] 09:07, 5 March 2009 (CST)
*****I agree that the classification seems outdated because of the extensive use ACS. But I have continued to code Unstable Angina and Coronary Insufficiency according to the data book descriptions. Fran--[[User:FLindell|FLindell]] 09:17, 5 March 2009 (CST)
 
******Could we add this to the meeting agenda?[[User:NMiller|NMiller]] 15:02, 4 March 2009 (CST)
 
*******I totally agree that ACS is not clarified enough in terms that we all can be on the same page. Alot of times on my ward, there is such poor charting that it doesn't even state how long the chest pain lasts or if was relieved by any intervention...I know hard to believe!! but true.Guidelines would be helpful. I do think we need to add this one for sure to agenda. (NOTE:  Whos' comment is this, it is not signed. thanks.


********We need to form a workgroup and have folks work on this one.   
********We need to form a workgroup and have folks work on this one.   
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::::::::C. How to remap then convert the previous codes into current ACS code.  The programmer would have to write a conversion.  
::::::::C. How to remap then convert the previous codes into current ACS code.  The programmer would have to write a conversion.  
::::::::::Volunteers for this working group or I will choose?  One of the collectors from STB should be on it since the "BIG Cardiology" team is there now.[[User:TOstryzniuk|TOstryzniuk]] 23:18, 11 March 2009 (CDT)
::::::::::Volunteers for this working group or I will choose?  One of the collectors from STB should be on it since the "BIG Cardiology" team is there now.[[User:TOstryzniuk|TOstryzniuk]] 23:18, 11 March 2009 (CDT)
********* I collect on B3 at HSC old Cardiology . The term ACS is usedand documented in my charts, which encompasses anything from USA to a NSTEMI. I have rarely seen Coronary Insuffiency documented by attending. I believe Janet Gada was working with Trish,to look at changing the terminology prior to her leaving HSC. Maybe someone at St. B could get in contact with her.--[[User:PStein|PStein]] 12:46, 12 March 2009 (CDT)
**********That was quite some time ago.  She left the position here at HSC & did not provide me with information was discussed. She had a copy of the "cardiac" DX codes from our code book that she was going to help with defintions.--[[User:TOstryzniuk|TOstryzniuk]] 14:36, 12 March 2009 (CDT)
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[[Category:Diagnosis Coding]]
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[[Category: Questions Diagnosis]]
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[[Category: Question for Data Collectors]]
[[Category: Question for Data Collectors]]

Revision as of 13:24, 9 April 2009

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:

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edit dx infobox
Category/Organ
System: 		Category: Unstable angina (old)

Type:

Category: UNSTABLE ANGINA (old)

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:


Also see Acute coronary insufficiency.

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


Discussion

  • At our most recent meeting on April 8,2009 Trish said if the doctors are calling the cardiac chest pain "unstable angina" code it that way. If they are calling the cardiac chest pain coronary insufficiency then code it that way.She mentioned taking away the definitions in the code book.

Template:Discussion

      • 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)
                • We need to form a workgroup and have folks work on this one.
A. what is types of cardiac problems are grouped under "ACS syndrome".
B. What is the new definition going to be.
C. How to remap then convert the previous codes into current ACS code. The programmer would have to write a conversion.
Volunteers for this working group or I will choose? One of the collectors from STB should be on it since the "BIG Cardiology" team is there now.TOstryzniuk 23:18, 11 March 2009 (CDT)

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