The medical definition of insult is damage or injury to ones body or organs. Therefore, the verbage that the physician used is simply stating that the patient has damage to the myocardium from anemia. When you look at myocardial damage in the ICD-9 it tells you to see also degeneration, myocardial (429.1). I would code that as 429.1 (primary) and 285.9 (secondary)
Hope that helps some!!
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