AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor

Fifth Digits for Acute Myocardial Infarction Transfers to Long-Term Care Hospital (LTCH)

We would like clarification regarding the correct use of the fifth digits for myocardial infarctions (MIs) in the long term care hospital (LTCH). Does the initial episode of care for MIs only include time spent in short term acute care hospitals? When the LTCH is licensed under acute care, would an acute myocardial infarction (AMI) that occurred in an acute care hospital that has not resolved under 8 weeks old have a fifth digit of “1” in the LTCH? Does it matter if the AMI was not resolved or resolved? Does a discharge/transfer from short-term acute care hospital to a LTCH make the MI fifth digit a “2”? ...

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