{"id":4094,"date":"2022-03-17T18:11:40","date_gmt":"2022-03-17T18:11:40","guid":{"rendered":"https:\/\/thedacare.org\/provider-portal\/?p=4094"},"modified":"2026-06-03T18:06:11","modified_gmt":"2026-06-03T18:06:11","slug":"diagnosis-update-on-demand-ischemia","status":"publish","type":"post","link":"https:\/\/thedacare.org\/provider-portal\/2022\/03\/17\/diagnosis-update-on-demand-ischemia\/","title":{"rendered":"Diagnosis Update on Demand Ischemia"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">ICD-10 codes published by CMS have recently changed to align with diagnosis included in the AHA 4<sup>th<\/sup> Universal Definitions for Myocardial Infarction.&nbsp; As a result of this national change, we have implemented new definitions for <strong>demand ischemia<\/strong> and <strong>myocardial injury.&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>New updated cardiology diagnosis definitions:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Acute Myocardial Injury<\/strong>: Rise and\/or fall in troponin with no ischemic findings. Essentially cardiac injury from a non-coronary source (e.g. supply\/demand mismatch)\n<ul class=\"wp-block-list\">\n<li>Most providers used to call this \u201cdemand ischemia\u201d<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Demand ischemia<\/strong>: NO troponin elevation. Ischemic findings due to supply mismatch without coronary arterial thrombosis\n<ul class=\"wp-block-list\">\n<li>Demand ischemia should be a rare diagnosis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">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.&nbsp; The CDI team will start to query for this as appropriate.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" height=\"580\" width=\"1024\" src=\"https:\/\/thedacare.org\/provider-portal\/wp-content\/uploads\/sites\/3\/2022\/03\/Pic-3.png?w=1024\" alt=\"\" class=\"wp-image-4095\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Hailey Ryfinski Clinical Documentation Manager <a href=\"mailto:-hailey.ryfinski@thedacare.org\">&#8211;<strong>hailey.ryfinski@thedacare.org<\/strong><\/a> 920\u2013203-2016<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Noel Gimenez Clinical Documentation Educator \u2013<a href=\"mailto:noel.gimenez@thedacare.org\"><strong>noel.gimenez@thedacare.org<\/strong><\/a> 920\u2013213 -3382<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ICD-10 codes published by CMS have recently changed to align with diagnosis included in the AHA 4th Universal Definitions for&#8230;<\/p>\n","protected":false},"author":98,"featured_media":3909,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[13],"tags":[],"class_list":["post-4094","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ad-hoc"],"jetpack_featured_media_url":"https:\/\/thedacare.org\/provider-portal\/wp-content\/uploads\/sites\/3\/2021\/10\/thedacare-logo.jpg","jetpack_sharing_enabled":true,"medium_card_thumbnail":"<img width=\"320\" height=\"180\" src=\"https:\/\/thedacare.org\/provider-portal\/wp-content\/uploads\/sites\/3\/2021\/10\/thedacare-logo.jpg?w=320&amp;h=180&amp;crop=1\" class=\"attachment-medium-card size-medium-card wp-post-image\" alt=\"ThedaCare Logo\" decoding=\"async\" loading=\"lazy\" \/>","post_categories":[{"term_id":13,"name":"Ad Hoc","slug":"ad-hoc","term_group":0,"term_taxonomy_id":13,"taxonomy":"category","description":"","parent":0,"count":16,"filter":"raw","cat_ID":13,"category_count":16,"category_description":"","cat_name":"Ad Hoc","category_nicename":"ad-hoc","category_parent":0}],"_links":{"self":[{"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/posts\/4094","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/users\/98"}],"replies":[{"embeddable":true,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/comments?post=4094"}],"version-history":[{"count":3,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/posts\/4094\/revisions"}],"predecessor-version":[{"id":4474,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/posts\/4094\/revisions\/4474"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/media\/3909"}],"wp:attachment":[{"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/media?parent=4094"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/categories?post=4094"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thedacare.org\/provider-portal\/wp-json\/wp\/v2\/tags?post=4094"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}