![]() ![]() initially selected 43 comorbidities that were used as potential risk factors for AMI in United States hospital report cards. To develop such a tool for AMI patients, Tu et al. Risk adjustment is an important tool used in health service research to account for differences in AMI patient's characteristics. We acknowledge that ACS 0940 'Ischaemic heart disease Acute Myocardial Infarction' refers to 'transferred' patients, however we consider that this should also apply to patients separated from hospital and readmitted.Acute myocardial infarction (AMI) outcomes are studied frequently in health service research with hospital discharge administrative data. If the patient is admitted (or transferred) to your hospital more than 28 days following the AMI, use the code for an 'old' AMIĮach case will depend on the individual circumstances.If the patient is admitted (or transferred) to your hospital within 28 days of the AMI, use the code for a current AMI.Once you have determined that the AMI requires coding, In the meantime, Victorian coders should adhere to the following advice.įor patients who have previously had an AMI who are admitted or transferred to your hospital, apply ACS 0001 'Principal Diagnosis' and ACS 0002 'Additional Diagnoses' to determine if the AMI should be coded. When the NCCH does provide a response to this query, the VICC will ensure to highlight this in the ICD Coding Newsletter to ensure that Victorian coders are aware of this. In light of this, the Committee has decided to provide an interim response that can be followed until the NCCH is in the position to provide a definitive position. A task has been created to investigate this matter further.Ī final decision will be added to the query database when available.' 'Due to the complexity of this issue, the NCCH is withholding a decision on this query in order to seek advice from the Cardiovascular CCCG and CSAC. The NCCH has been consulted with regards to this complex query, and has responded in the following manner: If the MI is not coded (and coronary artery disease is assigned as the principal diagnosis), the episode groups to DRG F15Z Percutaneous Coronary Angioplasty without AMI with Stent Insertion, WIES 1.871. Question: If a patient has an AMI, is treated, discharged home (within 5 days), referred to another hospital for PTCA and stent insertion and subsequently admitted to that hospital 10 days after discharge from the first hospital, should the AMI be coded by the hospital performing the PTCA and stent insertion? If the MI is coded, the episode groups to DRG F10Z Percutaneous Coronary Angioplasty with AMI, WIES = 2.3343. Basically coders are placing emphasis on two different things: 1) The 28 days or,2) The word “transferred”. Other coders are only assigning an AMI code during a subsequent episode of care if the patient is admitted for an initial episode of care for an AMI and subsequently transferred to another hospital within 28 days of the initial AMI (usually for treatment). Some interpret this to mean if a patient is treated for their AMI, discharged home then re-admitted to another hospital (or the same one) a few days later, the AMI should be coded during the subsequent episode if it is less than 28 days since the AMI first occurred. Coders are interpreting this standard differently. ![]() The 3rd paragraph of this section states “codes from category I21 should be assigned for an infarction in both the first hospital to which the patient is admitted for treatment and any other acute care facility to which the patient is transferred within 4 weeks (28 days) or less from onset of the infarction”. ACS 0940 Ischaemic heart disease, section title Acute Myocardial Infarction (Classification), pg 153. ![]()
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