Wiki Unstable Angina with MI in ICD-10-CM ?

[cmontyrn]

How are you handling documentation of Unstable Angina (USA) with MI in ICD-10-CM I no longer see the guideline regarding USA progressing to MI. If patient admitted with USA and found to have MI.. for the CAD code are you coding with or without Angina? Physician is documenting NSTEMI and CAD with unstable angina. Note: It was not post infarct angina.

 

[cteves]

CAD with Angina and Myocardial Infarction

Hi, you may use AHA ICD-10 Coding Handbook 2016 page 664.

Case
The patient, who had no history of bypass or angioplasty, was admitted with recurrent angina, which could not be controlled with medications and ultimately resulted in an acute ST elevation myocardial infarction of the anterior wall. On combined right and left cardiac catheterization with coronary cineangiography, a narrowing in the left anterior descending coronary artery and stenosis in the left circumflex and distal right coronary artery found. A successful 3-vessel coronary artery bypass graft was carried out. The left LIMA was used to bypass the anterior descending, and a reverse segment of the left saphenous vein graft was used to bypass the left circumflex and distal right coronary arteries. The left greater saphenous vein was harvested via a percutaneous endoscopic procedure.
Discharge Diagnosis:
I21.09 STEMI involving other coronary artery of anterior wall
I25.119 CAD with unspecified angina pectoris.

Christopher Teves, RN, CPC-A