AHA Coding Clinic® for ICD-9 - 2005 Issue 3; Ask the Editor

Apical Ballooning Syndrome

The patient is a 57-year-old female who was admitted with shortness of breath and chest pain. Electrocardiogram demonstrated inferior apical ST segment elevations. The patient was found to be hypotensive and in cardiogenic shock. She had an intra-aortic balloon pump placed and was started on Levophed. She was taken urgently to the cardiac catheterization laboratory and underwent left cardiac catheterization, coronary angiogram and left ventriculogram. The cardiac catheterization showed some minor disease of the obtuse marginal, but the other coronary arteries demonstrated no significant coronary artery disease. Left ventriculogram revealed marked apical ballooning consistent with LV apical ballooning syndrome. Her intra-aortic balloon pump was weaned and follow-up echocardiogram showed an excellent recovery of her left ventricular function with an ejection fraction of 65% and no thrombus. The physician documented apical ballooning syndrome. How should apical ballooning syndrome be coded? ...

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