# troponin



## crystal52599lhs (Aug 25, 2011)

***** What would you use for a diagnosis for " mild troponin leak " ?? 
 DATE OF SERVICE:           
 PROCEDURE PERFORMED:  Exercise treadmill test.  
 REFERRING PHYSICIAN:    
 INDICATION:  Mild troponin leak. 
 PROTOCOL:  Bruce.  
 TEST DURATION:  6 min and 17 seconds.  

 FINDINGS:  Peak heart rate of 173, which is actually above her predicted 
 maximal heart rate at 7.0 METS.  
 Symptoms:  None.  
 Test stopped due to:  Heart rate response.  
 Hemodynamic response:  Baseline.  
 Blood pressure:  172/80, rising to 204/84, peak exercise 210/60 early in 
 recovery.  
 Rest EKG:  Sinus rhythm with mild nonspecific ST-segment depression, 
 consistent with LVH or ischemia.  
 Stress EKG:  There was further ST-segment depression with stress.  The 
 remainder upsloping and because of the baseline changes and the upsloping 
 nature, it is technically nonspecific.  

 CONCLUSIONS:   

 1.  Limited exercise tolerance.  
 2.  Baseline hypertension that became aggravated with treadmill stress.  
 3.  Baseline electrocardiogram changes that became somewhat more impressive 
 with stress.  
 4.  Patient did not develop chest pain at a high cardiac workload.  This 
 test does not have imaging confirmation of ischemic threshold and was 
 suggested imaging test if there is a clinical indication for that.


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## mshay134 (Aug 25, 2011)

There is no ICD-9 code specific for elevated cardiac bimarker (troponin).  So the consensus has been to use:  790.5 Other Nonspecific Abnormal Serum Enzyme Levels.  Hope this helps


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