PMID- 18721504
OWN - NLM
STAT- MEDLINE
DCOM- 20080923
LR  - 20220316
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 102
IP  - 5
DP  - 2008 Sep 1
TI  - Is coding for myocardial infarction more accurate now that coding descriptions 
      have been clarified to distinguish ST-elevation myocardial infarction from non-ST 
      elevation myocardial infarction?
PG  - 513-7
LID - 10.1016/j.amjcard.2008.04.039 [doi]
AB  - Outcomes are typically graded on the basis of diagnoses coded according to the 
      International Classification of Diseases, Ninth Revision (ICD-9). To facilitate 
      performance measurement, the ICD-9 codes for acute myocardial infarction changed 
      in October 2005 to completely separate non-ST elevation myocardial infarction 
      (NSTEMI; code 410.71) and ST elevation myocardial infarction (STEMI; all other 
      codes 410.x), yet it is unclear whether these changes have been implemented by 
      coders. Patients in the National Registry of Myocardial Infarction (NRMI), 
      version 5, were categorized in 2 ways: by electrocardiographic (ECG) findings and 
      ICD-9 codes. Agreement between ECG findings and ICD-9 codes for type of 
      myocardial infarction (STEMI or NSTEMI) was assessed before and after ICD-9 
      revision. Mortality rates were measured in a subgroup of patients discharged 
      without transfer after the coding change. There were 102,679 hospitalizations 
      before October 2005 and 63,012 hospitalizations after the coding change, among 
      which the mean age was 66.7 years. Previously, 81% of NSTEMIs (by ECG diagnosis) 
      were coded ICD-9 410.71; after the reclassification of code 410.71 to reflect 
      NSTEMI, 82% of NSTEMIs were coded 410.71 (p <0.001). Overall, the correlation of 
      ECG diagnosis with ICD-9 code improved only slightly after the coding change. In 
      conclusion, despite more distinctly separated definitions of STEMI and NSTEMI in 
      the new ICD-9 coding system as of October 2005, there appears to be little change 
      in coding, which may reflect a lack of awareness of this substantial change in 
      classification.
FAU - Steinberg, Benjamin A
AU  - Steinberg BA
AD  - Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
FAU - French, William J
AU  - French WJ
FAU - Peterson, Eric
AU  - Peterson E
FAU - Frederick, Paul D
AU  - Frederick PD
FAU - Cannon, Christopher P
AU  - Cannon CP
CN  - National Registry of Myocardial Infarction Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20080626
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - *Electrocardiography
MH  - Female
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*classification/diagnosis/mortality
MH  - Registries/*statistics & numerical data
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - United States/epidemiology
EDAT- 2008/08/30 09:00
MHDA- 2008/09/24 09:00
CRDT- 2008/08/30 09:00
PHST- 2008/02/13 00:00 [received]
PHST- 2008/04/17 00:00 [revised]
PHST- 2008/04/17 00:00 [accepted]
PHST- 2008/08/30 09:00 [pubmed]
PHST- 2008/09/24 09:00 [medline]
PHST- 2008/08/30 09:00 [entrez]
AID - S0002-9149(08)00752-2 [pii]
AID - 10.1016/j.amjcard.2008.04.039 [doi]
PST - ppublish
SO  - Am J Cardiol. 2008 Sep 1;102(5):513-7. doi: 10.1016/j.amjcard.2008.04.039. Epub 
      2008 Jun 26.