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Wiki CAD/AMI question

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If a patient is admitted to a facility for chest pain and after careful study that patient is found to have a NSTEMI. The documentation indicates CAD or a history of CAD. I have seen CAD coded as prinicpal and the NSTEMI coded as the mcc. Is there a rule against this?
 
If a patient is admitted to a facility for chest pain and after careful study that patient is found to have a NSTEMI. The documentation indicates CAD or a history of CAD. I have seen CAD coded as prinicpal and the NSTEMI coded as the mcc. Is there a rule against this?[/QUOTE]
 
Ami/cad

AMI should be coded as primary dx since the AMI is documented as the cause as the chest pain. Even though the pt has CAD, this may not be the reason for the pain. AMI is also the acute condition and the reason for admission according to the info given.
 
You could find support for this in your Official ICD-9-CM Guidelines for Coding and Reporting, in the front section of your ICD-9-CM book; check the section relating to Selection of Principal/Primary Diagnosis.

Linda Templeton, CCS-P, CPC, CPC-H
 
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