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by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Question: Acute MI
I’m coding for hospital cath lab services. We had a patient transferred to us on 7/5 with elevated troponin and had initial chest pain at outlying hospital, chest pain had subsided, but 2 hours later had chest pain again and was transferred to us. Patient’s troponin had steadily increased on 7/6 and was taken to the cath lab on 7/6 and had a drug-eluting stent placed. Physician reported Acute MI-NSTEMI on the cath report.
Our question is when a patient isn’t taken to the cath lab emergently on that initial day being admitted/transfer, but physician dictates it as an Acute MI on the cath lab report, do we still code as Acute MI or DE stent? Not exactly sure if we should code it as an Acute MI because it wasn’t emergently, but had increased troponin.
To qualify for the “acute MI” CPT code 92941, you must emergently take the patient to the cath lab for intervention. This did not occur here. The patient still has an acute MI and the diagnosis code would reflect the NSTEMI (I21.4), but you would code the regular stent code (92928) in this case.
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