Thank you for viewing the chest pain MI registry September case scenario regarding sequence number 10207, medications prescribed at discharge, statin dose. In this scenario, an 87-year-old female with a past medical history of hypertension and diabetes presented to the emergency department complaining of shortness of breath prior to arrival. Labs were obtained and results revealed rising positive troponins. An ECG was negative for STEMI, however, inverted T waves were documented. A cardiology consult was obtained and NSTEMI was diagnosed. She was admitted to the progressive coronary care unit but decided against any procedural intervention. After an uneventful hospital stay, she was discharged on the following medications, aspirin 81 mg daily, clopidogrel 75 mg daily, Coreg 3.125 mg twice a day, lisinopril 40 mg daily and simvastatin 15 mg at bedtime. How is simvastatin 15 mg coded in sequence 10207, medication prescribed at discharge dose? Number one, low-intensity dose. Number two, moderate-intensity dose. Or number three, leave dose blank. Please take a few moments to review the documentation and question prior to making your final answer. The correct answer is low-intensity dose. Let us review why simvastatin 15 mg is coded as a low-intensity statin. The recommendation from the writing committee's chair of the 2018 Guideline on the Management of Blood Cholesterol document is to code any dosage that is in between intensity levels as the lower level intensity in sequence 10207. In this scenario, simvastatin 15 mg, which falls between moderate intensity, which is 20 to 40 mg, and low intensity, which is 10 mg, is coded as low-intensity. The exception to this rule is when a statin dose is not recommended. An example of this is simvastatin 80 mg. While simvastatin is classified as moderate intensity when the dosage is in between 20 to 40 mg, there is no high-intensity simvastatin dose recommendation. Simvastatin 80 mg should not be coded as moderate intensity due to the FDA warning clinicians against that drug-dose combo. For drugs and dosages that are not recommended, code yes to statin any, and the intensity or dose designation is left blank. Thank you for viewing the Chest Pain MI Registry September case scenario.

87-year-old female patient

shortness of breath

troponins

NSTEMI

simvastatin 15 mg at bedtime