Coding, Classification & Reimbursement

Reversible myocardial ischemia

  • 1.  Reversible myocardial ischemia

    Posted 01-11-2019 13:15
    ​Need some help.  Patient admitted for acute systolic/diastolic CHF.  No previous cardiac history but has alcohol and tobacco dependence.  Echo showed cardiomyopathy.  Cardiologist felt the etiology of the cardiomyopathy included chronic alcohol usage versus underlying CAD.  Myocardial perfusion scan was done which showed a small to moderate-sized focus of reversible myocardial ischemia within the septal wall with an EF of 15%.  Patient was transferred for cardiac catheterization.  Patient was not having any chest pain and able to walk the hallways w/o difficulty.

    Would this be coded to an abnormal stress test, I25.10 (CAD) or I25.9 (Ischemic heart disease NOS)?

    Appreciate thoughts/suggestions

    Paula Scheiderich, RHIT
    Clinical Documentation Improvement
    Oneida Healthcare Center

  • 2.  RE: Reversible myocardial ischemia

    Posted 01-12-2019 10:37
    The cardiologist has reached no definitive diagnosis, but his treatment plan on transfer has been directed to his  "underlying" CAD.

    i25.9 is an unspecified form of ischemia, while i25.10 is a specified form. This is the PD.


    Louise Smalling
    Senior Medical Coder

  • 3.  RE: Reversible myocardial ischemia

    Posted 01-13-2019 19:29
    ?Thank you for your response Louise.