Cardiology Question for the Week of August 28, 2017

Question:

Can you provide any information about the new ICD-10 coding guidelines for MI?

Answer:

The August 15, 2017 online issue of ICD10monitor includes an article by Erica E. Remer, MD, FACEP, CCDS entitled “Learning ICD-10: Documenting Type 2 Myocardial Infarction” (MI) that provides details about the guidelines for fiscal year (FY) 2018. For this article, go to https://www.icd10monitor.com/learning-icd-10-documenting-type-2-myocardial-infarction.

The article includes the following information:

• The new guidelines reflect the “implication that a Type 2 MI is different than a Type 1 MI.”
• There is now a unique code for Type 2 MI, I21.A1. Remer says, “It does not need artery site specification because that is not relevant. Its significance is that it imparts a more serious prognosis to the causative underlying condition.“
• Guideline I.C.9.e.5 specifies that “MI due to demand ischemia or secondary to ischemic (im)balance is assigned to Type 2 MI and not I24.8, Other forms of acute ischemic heart disease.” Accordiing to Remer, coders sometimes disregard the “Type 2 MI” verbiage and only code the “due to demand ischemia” with I24.8, which does not capture the patient’s severity of illness or complexity.