ED Coding and Reimbursement Alert

Question: What exactly is "angina pectoris" and what is the proper diagnosis code for this condition?

Missouri Subscriber

Answer: Also known as simply "angina," angina pectoris is the medical term for chest pain, usually caused by coronary artery disease. Patients may experience angina as constricting chest pain, perhaps radiating from the left shoulder and arm. Angina often presents as "attacks" that occur with provocation, such as exercise or emotional excitement.

Not all anginas are alike; several types exist, and they have corresponding diagnoses codes:

- Stable angina occurs when a patient has recurring episodes of chest pain that are fairly predictable --regularly occurring with exertion, for instance. Report stable angina not classified with any more information as 413.9 (Other and unspecified angina pectoris)

- Unstable angina is an acute coronary condition in which the pain occurs unexpectedly and often does not abate while the patient is at rest. This condition can be an immediate precursor to a heart attack. If the patient presents with unstable angina and does not advance to a more serious condition, you should code it as 411.1 (Intermediate coronary syndrome).

- Variant angina (also called Prinzmetal's angina) occurs while the patient is lying down and at rest. The cause is transient spasm of the coronary artery, which is often associated with ST-segment elevations on an electrocardiogram (ECG). Code this condition as 413.1 (Prinzmetal angina).