AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2021 Issue 3; Ask the Editor

Non-ST Elevated Myocardial Infarction and In-Stent Restenosis (Culprit Lesion)

A patient, who has known coronary artery disease (CAD) status post coronary artery intervention with stent insertion, is admitted due to acute non-ST elevated myocardial infarction (NSTEMI). Coronary angiography demonstrates multiple vessel CAD. The provider’s final diagnostic statement lists, “Previously placed stent in the mid right coronary artery with a focal area of in-stent restenosis, which is the culprit lesion.” Some coding professionals are interpreting “culprit lesion” as disease progression rather than a complication of the stent. How should this case be coded? ...

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