If a coder incorrectly assigns the code for a NSTEMI (I21.4) the case will be inappropriately pulled into the National Cardiovascular Data Registry and included in the CMS cohort for 30-day readmission rate and 30-day mortality rate.Ģ020 Official Guidelines for Coding and Reporting According to the Official Guidelines for Coding and Reporting, when Type 2 NSTEMI is documented, the code for Type 2 MI should be assigned and the code for NSTEMI should be withheld.
Type 2 Non-ST elevation MI (NSTEMI) is a problematic term. These terms map to ICD-10-CM code, I21.A1, MI Type 2.
MI due to demand ischemia or MI secondary to ischemic imbalance are equivalent to Type 2 MI from a coding perspective. If the patient does not meet one of the criteria for myocardial ischemia, the patient should not be diagnosed with a Type 2 MI. When considering a Type 2 MI diagnosis, a common mistake is to forget about the requirement of acute myocardial ischemia. Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischemic etiology.Symptoms of myocardial ischemia (shortness of breath, etc.).Evidence of imbalance between myocardial oxygen supply and demand causing acute myocardial ischemia (one of the criteria below):.Myocardial injury as evidenced by cTn > 99th percentile upper reference limit (URL), AND.To diagnose a Type 2 MI, there needs to be:
Type 2 MI is frequently incorrectly diagnosed and inconsistently documented. Documentation and coding myocardial infarction (MI) is a common pain point for CDI departments, caused by conflicting or incomplete documentation that requires further clarification with a query.
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