ICD-10-CM Specific Coding Guidelines - How to Code AMI's and Other Circulatory Procedures

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all right a patient was admitted with an

acute myocardial infraction 10 days

later he is admitted for an acute

anterior lateral infraction CER your

time begins now and good

luck

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okay yeah this was a little tough one

right yeah but I think it's just um

breaking them down and really

understanding what you're coding for

right what is this how do we have on

okay there we go so we have an acute my

cardial infarction so the patient was

admitted 10 days ago for an acute

myocardial

infection then 10 days later right

they're admitted again for an acute

anterolateral

infarction so it turns out we need to

code for the current one right so let's

assume we already build and code for

that previous one but we need to code

for the reason for the encounter the

reason for the encounter

is the recurring one right so let's look

at our chart so if they were if they had

a previous infarction and that

infarction was 28 days or less then

we're going to sequence it like this

i22 for this one the recurring one and

then

i21 this is what we're going going to

do are you with me so let's go ahead and

document patient had a Ami 10 days

ago and the patient's having an acute

anterolateral

infarction

today now let's go ahead and look up

this acute anal lateral in far ction

today because this will be the reason

for the encounter right and we're going

to sequence it first so let's look up

infarction subsequent right it's

subsequent it's an acute one but it's

subsequent

recurring infarction and then let's go

down and look underneath that right

anterior

anteroapical anol vatal

andal I

22.0 this is the first one so let's go

to

i22 subsequent

St and and

semi and let's go down this is the right

category I2 2.0 subsequent St elevation

of an an terior wall and underneath

subsequent anterolateral transmural Q

wave inunction

acute this is first I

22.0 are you with me yes somebody saying

yeah you should be happy you knocked it

out the park yes you did okay so this is

the first one we're coding for the

recurring one first next

we got a code for for that previous

inunction right and that previous

infrction is

still it's still um acute because it is

less it's 28 days or less so it's still

acute and we still use these acute codes

so we're going to go to

infarction what was this infarction it

just says an acute mardial infarction so

infarction my

cardium if it was four weeks or less I

to

1.9 I like that because there's no

mention of the sight of the infarction

or the type right yeah so I like

it I2 2.0 is first I2 1.9 is second and

look down here acute my cardial

infarction not otherwise specified acute

my cardial infarction we don't know what

type or anything about that previous

infraction and remember it's I 21.9 when

the type in the coronary vessel is

unknown so we don't know the location of

the infraction on the heart and we don't

know the type now if the type is known

and not the vessel I to 1.3

all

right are you all with me did that make

sense all

right yeah when you just break it down

in those digestible

nuggets it is perfect it's easier when

you do that outstanding job out I see

some I see all kinds of lights going off

I do aha aha aha all right Miss

Stephanie please and thank

you coders A 122.8 and

12.09 B

12111 and

122.0 c 122.0 and d 122.0 0 And1

21.11 two days after being admitted for

a right quinary acute myocardial

infraction a patient suffers a new anti

antio Excuse Me Pickle myocardial

infraction of the right coronary vessel

the patient is being seen for a new

infraction your time begins now and I

know you got

this

e

aha all right I love it I love it I love

it yes I see all kinds of you know

comments in here that just say hey I got

it I got it and I love it all right so

let's go ahead and let's code this

out but first my what am I doing here I

got I'm eliminating stuff

without um come on let's do

this there we

go all right there we go there's our

inventory this patient was

admitted two days ago well I guess this

charged two days ago right and they had

a

right coronary myocardial

infarction and today they have a new

Andro appical myocardial

infarction so this is a subsequent

infarction

right and the way you are going to code

this subsequent infarction we're going

to use the same guideline they had a

previous Ami and it's not older than

four

weeks so we're going to sequence i22

first Follow by

i21 and D is the answer somebody said

and D is the answer it is it is because

it's sequenced appropriately

now let's go ahead and do our due

diligence we're going to look these up

right and we're not going to look it up

from the index because we're

given we're given the answers so if you

look at I 22.0 this is the code for

subsequent anro appical transmural qwave

infarction this is

correct right so I2 2.0 is correct and

let's look at I2 2

1.11 this is the code for St this is for

the first infarction the acute right

right coronary infarction two days ago

and it's

still current it's still new so we still

use these acute codes I 21.11 st stemi

involving the right coronary

artery and that that is correct as

opposed to I2

1.01 because this is coding for an other

coronary artery vessel we already know

it's the right coronary vessel here not

other so we're going to get rid of a and

the answer is

D all right how are you feeling you are

doing this you're doing it you should

really really feel good someone said

which one is the reason for the

encounter the first or the second the

reason for the encounter will be what is

happening now right now that

documentation for that other infarction

the previous one is already going to be

coded so we're only dealing in the

current right so whatever is happening

now that is going to be the reason for

the

encounter great

question absolutely someone said are we

allowed to write more notes in the MCG

manual yes