STEMI coding for eCQM's

BrandeiskyJohnBrandeiskyJohn
in Clinical & Coding

Hi all, we are looking for clarification on documentation and coding of a STEMI in the medical record according to ACDIS and Coding compliance: 

If a patient comes in with chest pain to the Emergency Department and the next several EKG's do not show a STEMI while in the Emergency Department, then gets admitted after the second or third EKG showing no progression to STEMI in the ED, and then one or two days later develops a STEMI on EKG after being admitted, does that code to present on admission - yes in the ED? 

Here are three examples /scenarios in which our coding/CDI stated must be coded as STEMI POA- (Present on Admission) - Yes: 

  1. NSTEMI in ED that evolves to a STEMI after  the patient is admitted 
  2. STEMI occurring after  admission where….. 
  • EKGs in the ED did not show STEMI (7/14/23) 
  • Onset of chest pain after admission in which EKG showed STEMI (7/16/23) 
  1. 3. A patient emergently brought to the cath lab which showed a thrombosis of a previous stent (7/16/23) when the patient has a history of acute STEMI 4 weeks prior to admission  

 

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