Wiki Coding a MI

[Chelsea1]

I am in need of help with coding MI's.

I know that you would code a 92941 for a acute STEMI, however what is the code for a NON-STEMI? I dont know if it is also a 92941 or is it a 92928?

If anyone could clear this up for me, I would appreciate it. I tried to find the information out but could not find any so if you also could direct me to some written information, I would really appreciate it.

Thanks

 

[lbellomy13]

Answer

Per the AMA in Jan 2014, a NSTEMI does not fulfill the designation of an acute myocardial infarction unless there are ongoing symptoms prompting emergent activation of the catherization laboratory with demonstration of a subtotal or total coronary occlusion of the culprit vessel.

This came from "Diagnostic & Therapeutic Cardiac Catherization Coder" 2017 edition published by MedLearn. I have used this publication for years.

 

[csdarrow@hotmail.com]

Do not choose your cath code due to Dx

When coding with cardiac catheterization codes; the code 92941 is used for an acute myocardial infarction that necessitates rapid intervention and is critical to reopen a blocked artery. You must have documentation of this being an emergency and a ‘door to balloon’ time of 90 minutes or less. 92941 includes any or all of these interventions: stent placement, atherectomy, angioplasty, manual aspiration of a thrombus (mechanical may be coded separately), distal embolic protection. If a patient comes to the cath lab with NSTEMI (I21.4), you must read your physician’s documentation to choose CPT codes depending on what, if any interventions he performed. Everyone does not get a stent (92928) just because of a diagnosis of NSTEMI. There must be a diagnosis of significant arterial blockage, which would be 70% or greater in order for the physician to place a stent. Angioplasty is often used when there is less severe narrowing or blockage in the arteries. Angioplasty is also used as an emergency procedure during a heart attack. Quickly opening a blockage lessens damage to the heart muscle and that makes angioplasty sometimes the best approach during a heart attack. The disadvantage though is that the artery may become narrowed again over time necessitating a repeat intervention.
Christine Darrow CPC, CPMA