Demand infarct

This is my week for questions, apparently. How would you code the term
"demand infarct"? Here is the exact wording from the discharge summary:



RIMARY DIAGNOSES:

1. Atrial fibrillation with atrial flutter with a 1 to 1 conduction.

2. Demand infarct, troponin leak from problem #1.

3. Chest wall tenderness, musculoskeletal.

4. Parkinson dementia.

5. Chronic diastolic congestive heart failure with ejection fraction of

55%. No signs of exacerbation.



BTW, troponin I was 0.643 and 0.637, c/w WHO criteria for MI.







Cathy Seluke, RN, BSN, ACM, CCDS

Supervisor Clinical Documentation Compliance

MaineGeneral Medical Center

Augusta and Waterville, Maine

(207) 872-1796

Cathy.Seluke@mainegeneral.org

Comments

  • yes



    Ann-Marie Carducci, RN, MPA, CPHM, CPHQ, CPC, CCS, CCDS

    Director, Utilization Management

    Montefiore Medical Center

    914-377-4678 - Yonkers Office

    718-904-2695 Einstein Office

    917-574-6781 - Cell

    email: acarducc@montefiore.org


  • HI, we always query to further clarify this term. There is no code, per our coders and the ICD 9 book for this term. It will be interesting to hear other responses.


  • edited May 2016
    Because there is no distinct code for demand ischemia, it is recommended that the physician be queried.
    If no additional clarification can be obtained, go with 411.89. To use this code make sure the physician states that this is an acute condition.

    Francisca Wojciechowski, BS, RHiA, RHIT, CCDS



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