07-02-2018, 05:30 AM | Community Wiki

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Stemi help!!

  1. #1
    Jacksonville, NC
    Default Stemi help!!
    Medical Coding Books
    I have a patient with an anterior AMI, whose "culprit vessel" is a LIMA graft. I'm trying to figure out which STEMI code to use for the diagnosis. The native vessel it connects into is the LAD. Do I just use I21.02? Or do I use a code for other sites I21.29?

    Megan C, CPC, CIRCC, CCC

  2. #2
    I would use I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall. Anterior wall was stated which satisfies the fourth digit and LIMA graft would satisfy the 5th digit for other specified artery.

    Anterior wall was specifically stated, so I would code at least something from the I21.0X category instead of I21.29. Grafts aren't listed in the inclusion terms for I21.29, so I personally use that one either.
    Ivan Balza, CCS, CPC, CDEO, CPMA, CRC
    President, Corona California Chapter

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