Advice

How do I code NSTEMI Type 2?

How do I code NSTEMI Type 2?

Sequencing of type 2 AMI or the underlying cause is dependent on the circumstances of admission. When If a type 2 AMI code is described as NSTEMI or STEMI, only assign code I21. A1. Codes I21.

Is there such thing as a Type 2 NSTEMI?

(NSTEMI) is a common diagnosis in hospitalized patients. Type 2 has been reported up to 25% of cases of MI depending on the population studied. Type 2 NSTEMI is defined as myocardial ischemia resulting from mismatched myocardial oxygen supply and demand that is not related to unstable coronary artery disease (CAD).

What is the ICD-10 code for MI type 2?

ICD-10 Code for Myocardial Infarction (Type 2) Type 2 MI (whether a new initial or subsequent) is assigned to one code (I21. A1). The code also includes any description of MI due to ‘demand ischemia’ or ‘ischemic imbalance. ‘

What is type II myocardial infarction?

Type 2 myocardial infarction (MI) is defined by a rise and fall of cardiac biomarkers and evidence of ischemia without unstable coronary artery disease (CAD), due to a mismatch in myocardial oxygen supply and demand. Myocardial injury is similar but does not meet clinical criteria for MI.

Is type 2 MI the same as demand ischemia?

Demand ischemia should be reserved for when there is evidence of supply-demand mismatch causing ischemia without an elevated troponin above the 99th percentile. If the troponin is > 99th percentile the diagnosis is a Type 2 MI.

What is Type 1 and Type 2 MI?

Type 1 MI is a primary coronary arterial event attributable to atherothrombotic plaque rupture or erosion. Type 2 MI occurs secondary to an acute imbalance in myocardial oxygen supply and demand without atherothrombosis.

Is type 2 MI STEMI or NSTEMI?

Figure 1: Classification of MI

MI Type Classification
1 STEMI (acute coronary artery thrombosis) NSTEMI (acute coronary artery plaque rupture/erosion)
2 Supply/demand mismatch (heterogeneous underlying causes)
3 Sudden cardiac death with ECG evidence of acute myocardial ischemia before cardiac troponins could be drawn

Is NSTEMI type 1 or type 2 MI?

Most NSTEMI (65%–90%) are type 1 MI. Patients with type 2 MI have multiple comorbidities and causes of in-hospital mortality among these patients are not always CV-related.

Is demand ischemia the same as Type 2 MI?

Supply/demand ischemia can be either “demand ischemia” (no infarction) or “Type 2 MI” (infarction due to supply/demand mismatch). Because the troponins were within the normal range, this would not be classified as a Type 2 myocardial infarction.

What is NSTEMI diagnosis?

An NSTEMI is diagnosed when your EKG does not show the type of abnormality seen in a STEMI but your blood tests show that your heart is stressed. Unstable angina. This is the least severe type of ACS. It can be caused when a blood clot blocks a coronary artery partially or totally.

How is type 2 MI diagnosed?

Patients who present with abdominal discomfort and shortness of breath may have their cardiac troponin level measured, which, if combined with other features such as ischemic ECG changes and symptoms, may lead to a type 2 MI diagnosis.

How can you tell the difference between Type 1 and 2 NSTEMI?

For patients with type 1 MI, the focus is on aggressive antithrombotic therapy and consideration of urgent coronary angiography and revascularization. For patients with type 2 MI, the focus is on treating the extracardiac stressor precipitating the myocardial oxygen supply and demand imbalance.

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