Thank you for viewing the Chest Pain MI Registry April case scenario for 2022, where we will discuss inclusion criteria. A 67-year-old male arrived at the emergency department on January 26, 2022, at 7.10 a.m. and was diagnosed with sepsis, secondary to an infected ICD. IV antibiotics were initiated. While it was stabilized, the patient was transferred on January 28, 2022, at 10 a.m. as a direct admit to the second facility for an ICD extraction, which occurred at 14.00 that same day. One hour after that procedure, while still in the cath lab holding area, the patient complained of chest pain. The monitor revealed STEMI. A code STEMI was called and the patient went emergently into the cath lab for PCI to the RCA. Primary discharge diagnosis ICD extraction with secondary diagnosis of inferior wall STEMI. Our question is regarding facility number two. Is this patient included in the Chest Pain MI Registry? Number one, no, or number two, yes. Please take a few moments to review the documentation and the question before making your final response. The answer is number two, yes. This patient is included in the Chest Pain MI Registry at the second facility. Our follow-up question number two, how are sequence 12360 patient type and sequence 12447 STEMI setting coded? Number one, STEMI and pre-admit, or number two, STEMI and in-hospital? Please take a few moments to review the documentation and the question before making your final answer. And the answer is number two. The patient type is coded as STEMI with in-hospital coded as the STEMI setting. Per the inclusion criteria, patients arriving for scheduled procedures, elective cath, surgeries, are not included unless an in-hospital STEMI occurs, and the in-hospital STEMI occurs after orders for admission. In other words, the diagnostic ECG occurs after cardiac or non-cardiac admission orders have been written, as in the presented scenario. The exclusion criteria regarding transferring greater than 24 hours after arrival to the first facility does not apply when the in-hospital STEMI occurs at the second facility. Additionally, the in-hospital STEMI requires only a diagnosis of STEMI to be included in the registry. The order in which the diagnosis are listed, examples primary, secondary, et cetera, does not affect inclusion. Transferred from outside facility in sequence 12-4-2-1 is not an option for the in-hospital STEMI patient, as sequence 12-4-2-1 does not open for selection. Transferred from outside facility with subsequent child fields are completed for the pre-admit STEMI and STEMI, unstable angina, and the low-risk chest pain patients. Transfer information, such as means of transport to the first facility or hospital, can be captured as the coding instruction is, indicate the date and time the patient was first evaluated by EMS prior to arrival at first facility. ECGs have a target value of 24 hours prior to first medical contact and discharge and can be coded when the target value is met. Lab values cannot be captured for the in-hospital STEMI patient when the target values are not met. Please code only those labs performed at your facility. Thank you for viewing the Chest Pain MI Registry's April case scenario for 2022 regarding inclusion criteria.

Chest Pain MI Registry

STEMI

in-hospital STEMI

coding

viewers