Patient evaluation prior testing is completed when sequence 12360 patient type is NSTEMI, unstable angina, or low risk chest pain. This section does not apply to the STEMI patient. Sequence 15457 functional test results seeks to capture the results of the functional imaging stress test occurring between one year prior to arrival at this facility and arrival at this facility. Please take this opportunity to strike out the and, or from your data dictionary and add stress to the notes section as this section is only capturing stress tests. The following are definitions for negative functional stress test results. Stabilized stress test without imaging is negative when the ECG is normal or not suggestive of ischemia. ECGs are not suggestive of ischemia when less than one millimeter of horizontal or downward sloping ST segment depression or elevation greater than or equal to 60 to 80 milliseconds after the end of the QRS complex, either during or after exercise. Stress echocardiogram is negative when the imaging study was normal. There were no changes in wall motion during the exercise. Stress nuclear test is negative when the results of the imaging study revealed no myocardial perfusion defects. Stress imaging with CMR is negative when the results of the imaging study revealed no myocardial perfusion defects. The following are definitions for positive functional stress test results. Exercise stress test without imaging is positive when the ECG suggests ischemia. ECGs suggestive of ischemia can be described as having greater than or equal to one millimeter of horizontal or down sloping ST segment depression or elevation for greater than or equal to 60 to 80 milliseconds after the end of the QRS complex, either during or after exercise. It is also suggestive of ischemia if the patient has symptoms of ischemia such as chest pain, arrhythmias and or a fall in blood pressure during or immediately after the procedure. Stress echocardiogram is positive when the imaging study was abnormal. There were changes that reflected wall motion abnormalities during the procedure. Stress nuclear test is positive when the results of the imaging study revealed one or more stress-induced myocardial perfusion defects. Stress imaging with CMR is positive when the results of the imaging study revealed one or more stress-induced myocardial perfusion defects. Indeterminate indicates the results of the functional test were uninterpretable. They cannot be considered positive or negative. Unavailable indicates the results of the functional stress test were not available. Not performed indicates the functional stress test was not performed. CRS 15458 anatomical imaging results seeks to capture the results of the anatomical imaging. These imaging studies include CTA and diagnostic calf preformed between two years prior to arrival at this facility and arrival at this facility. The following are definitions for anatomical imaging results. No CAD indicates the patient has clear coronary arteries. No disease was identified in any native or graft vessel greater than two millimeters. CAD indicates the patient has coronary atherosclerotic disease identified in at least one native or graft vessel greater than two millimeters. Unavailable indicates there are no results available. Not performed indicates the imaging study was not performed. When both a cardiac CTA and diagnostic calf are performed, first capture the most recent test whether it be CTA or coronary angiogram performed within the target value. If both were done on the same day and the times are available, code the most recent test performed. Sequence 15459 CAD type seeks to capture the type of coronary artery disease diagnosed by the most recent anatomical imaging performed between two years prior to arrival at this facility and arrival at this facility. The following are definitions for CAD type. Please note only disease found in vessels greater than or equal to two millimeters is captured unless a vessel is less than two millimeters and is intended for PCI and or the patient's overall coronary anatomy is less than two millimeters. Non-obstructive indicates the disease is less than 50% in all coronary vessels and left main disease is less than 50%. Moderate indicates the disease is 50 to 69% in any coronary vessel defined as the left anterior descending, the left circumflex, the right coronary artery, and any of their branches. A true ramus branch greater than two millimeters. Any bypass graft and left main disease less than 50%. Obstructive indicates the disease is greater than or equal to 70% in any coronary vessel defined as the left anterior descending, the left circumflex, the right coronary artery, or any of their branches. A true ramus greater than two millimeters. Any bypass graft and or left main disease greater than or equal to 50%. Known indicates the CAD type of disease is not known. Differentiating between non-obstructive and moderate CAD types. The left main coronary artery must have less than 50% stenosis. Then if all other coronary vessels have less than 50% stenosis, code non-obstructive. If any other coronary vessel has 50 to 69% stenosis, code moderate.

patient evaluation

functional stress tests

anatomical imaging

NSTEMI

unstable angina