ICD-10 codes published by CMS have recently changed to align with diagnosis included in the AHA 4th Universal Definitions for Myocardial Infarction. As a result of this national change, we have implemented new definitions for demand ischemia and myocardial injury.
New updated cardiology diagnosis definitions:
- Acute Myocardial Injury: Rise and/or fall in troponin with no ischemic findings. Essentially cardiac injury from a non-coronary source (e.g. supply/demand mismatch)
- Most providers used to call this “demand ischemia”
- Demand ischemia: NO troponin elevation. Ischemic findings due to supply mismatch without coronary arterial thrombosis
- Demand ischemia should be a rare diagnosis
These guidelines have been created with and approved by our Clinical Documentation Improvement Medical Director, Dr. Samuel Pierre, and the ThedaCare Cardiology Catheterization Lab Medical Director, Dr. Sam Kapphahn. The CDI team will start to query for this as appropriate.
Hailey Ryfinski Clinical Documentation Manager -hailey.ryfinski@thedacare.org 920–203-2016
Noel Gimenez Clinical Documentation Educator –noel.gimenez@thedacare.org 920–213 -3382