'Department of Health and Human services, Victoria, Australia'

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Aborted STEMI/AMI

Publication Date: March 2015

ICD 10 AM Edition: Eighth edition

Query Number: 2969

When a patient presents as STEMI/AMI, but myocardial damage is completely averted by prompt revascularization, and there is documentation of averted or aborted MI in the patient record, what is the correct code to assign?

Would I24.0 Coronary thrombosis not resulting in myocardial infarction be the correct code to assign?

Definition:
Abortion of myocardial infarction is thought to follow rapid early reperfusion of a thrombotic occlusion of an epicardial coronary artery such that myocardial necrosis cannot be detected by classical plasma enzyme analyses.
Verheugt et al, Eur Heart J, 2006

Response

VICC understands that with early intervention of reperfusion therapy, myocardial necrosis can be prevented in some patients and this is referred to as 'aborting' the myocardial infarction.

As there is no essential modifier for documentation of 'aborted' under Index entry Infarction/myocardium/STEMI NEC, VICC considers that the correct code to assign is the default code I21.3 Acute transmural myocardial infarction of unspecified site. This is supported by the clinical notes provided with this query, which states the principal diagnosis as STEMI.