Myocardial infarction
{{PreICD10 dx | NewDxArticle = Myocardial infarction, acute (AMI), NOS
| NewDxArticle = Myocardial infarction, actue (AMI), transmural (Q-wave)
| NewDxArticle = Myocardial infarction, acute (AMI), subendocardial/non-transmural (non-Q-wave)
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(old) (old) |
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Type: |
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| Main Diagnosis: | Myocardial infarction |
| Sub Diagnosis: | Yes-see Myocardial infarction |
| Diagnosis Code: | 10200 - Myocardial Infarction
Item below not allowed in comorbid
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| Comorbid Diagnosis: | Yes |
| Charlson Comorbid coding (pre ICD10): | 1 |
| Program: | CC & Med |
| Status: | Currently Collected
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Criteria
- Documented CPK rise or classic EKG changes
Proposed coding of type 2 MI
- 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)
Discussion - elimination of subcodes
- I would like to move away from using any of the subcodes for MI's in COMORBID coding, just allow 10200 if pt had an MI in past prior to hosp admission. Thought it is nice to have there is no value added to comorbid calculation, and also coding is not consistent because chart notes frequently don't indicate the location of the heart where MI had occurred in the past. --TOstryzniuk 17:48, 23 December 2010 (CST)
- If you want I can make the subcodes unavailable as comos; just say the word. Ttenbergen 17:45, 2012 October 31 (EDT) Template:Potential Change
Discussion - subdxs not mutually exclusive
- 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 should be eliminated. (The same is probably true for other dxs) 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 Diagnosis? 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.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?--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
- In past discussion with Trish, when I collected CCU here at HSC, Trish had indicated that only one Dx of MI should be captured, otherwise it indicates 2 episodes of MI. The post-op MI is of more significance because it indicates both MI and complication. --FLindell 12:58, 5 November 2010 (CDT)
- I'll ping this old discussion to see if we can resolve. Ttenbergen 14:18, 2012 September 5 (CDT)
- 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 Diagnosis? 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.Ttenbergen 12:56, 18 February 2009 (CST)
Template:CCMDB Data Integrity Checks
- If 102-10 (MI Aborted with TPA) you must not use any another 102 with a subcode.
- This rule is not yet implemented in ACCESS.
- Template:Discussion That's because this rule is not documented (or show me where). Pls document and address the above questions (since the answer could modify any such check) and then add to Requested Changes. Ttenbergen 01:45, 2012 November 2 (EDT)14:20, 2012 September 5 (CDT) 17:06, 4 November 2010 (CDT)