Heart disease and heart conditions: Part II
Editor’s note: This is part two of four heart disease-related posts. Part one can be found here.
Coronary artery disease is one of the primary causes of acute myocardial infarction, commonly known as a heart attack. Plaque in the coronary arteries can break off and form a blood clot, which deprives the heart of oxygen and other essential nutrients and results in damage or death to the heart muscle. Symptoms of heart attack include chest pain, pain or discomfort in the back, arms, neck, and upper body, shortness of breath, lightheadedness, and nausea. Someone in the United States suffers a heart attack approximately every 34 seconds, according to the American Heart Association.
Acute myocardial infarction – ICD-9-CM category 410.xx or ICD-10-CM categories I21 and I22.
When assigning codes in ICD-9-CM, the fourth digit identifies the specific wall where the infarction occurred as well as the episode of care (initial or subsequent) for that AMI. AMIs are defined as one where the symptoms have lasted eight weeks or less. ICD-10-CM offers more specific detail in identifying the specific wall but goes further and can identify the specific vessel involved (left circumflex or right coronary artery). ICD-10-CM also has distinctive code assignment to identify AMIs as being ones with symptoms lasting four weeks or less.
AMIs can be identified with category I21 or I22. The code description for I22 states “subsequent” AMI and has a different meaning that subsequent episode like in ICD-9-CM. I22 is assigned for AMIs where the patient has suffered another AMI within the previous four weeks. I22 can never be used as a standalone code and must be accompanied by a code from I21 to identify the site the AMI suffered within the previous four weeks occurred. Code sequencing would be based on the encounter.
Editor’s note: To be continued in Part III.
About the Author: Shannon McCall. RHIA, CCS, CCS-P, CPC, CEMC, CPC-I, CCDS
Director of coding and HIM at HCPro, Inc., currently serves as the Director of HIM and Coding for HCPro, Inc. She manages the instructors of the Certified Coder Boot Camps,® which cover physician and outpatient hospital coding and inpatient hospital facility coding. McCall is HCPro’s Revenue Cycle Institute lead coding expert, where she works with hospitals, medical practices, and other healthcare providers on a wide range of coding-related issues. McCall has extensive experience with coding for both physician and hospital services. She is recognized as an official ICD-10 educator through the American Health Information Management Association (AHIMA).
