Health Information Management

Tip: Timeline for AMI changing in ICD-10-CM

APCs Insider, January 17, 2014

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Currently in ICD-9-CM, a myocardial infarction is considered to be acute when stated as such or for a stated duration of eight weeks or less and still symptomatic. ICD-10-CM shortens that to a four-week time frame. Another thing to note is the change in the meaning of “initial” and “subsequent.”
In ICD-9-CM (category 410.9x), initial and subsequent used in the code description refer to the episode of care. Is the patient presenting for initial treatment for a newly diagnosed acute myocardial infarction (AMI) or for further observation, evaluation, or treatment for an AMI that has already received initial treatment but is still less than eight weeks old?
In ICD-10-CM, coders will still identify similar information where determinations must be made for proper code assignment by identifying how many AMIs the patient has suffered in a four-week time period. The first or “initial” AMI will be represented by a code from category I21. Coders will assign a code from category I22 to identify a “subsequent AMI” within a four-week time frame (regardless of site). Both codes must be assigned and sequencing can vary on the circumstances of the admission but,  per the Official Guidelines for Coding and Reporting, I22 cannot be used alone.
 
This tip is adapted from “This month's coding Q&A” in the January issue of Briefings on APCs.



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