AHA Coding Clinic® for ICD-9 - 2007 Issue 3; Clarifications
Aborted Stroke
The Central Office on ICD-9-CM has received several questions concerning the validity of advice about “aborted stroke†published in Coding Clinic, First Quarter 2007, pages 23-34. Although this advice appears to conflict with information published in Coding Clinic, Second Quarter 2001, pages 7-8, regarding “aborted myocardial infarction (MI),†these cases are clinically different. In terms of the aborted MI, the patient presented with severe chest pain resembling an acute MI. After tissue plasminogen activator (tPA) was administered, the MI was averted with no evidence of injury to the...
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Article Overview
This article reviews Coding Clinic discussion about the term “aborted stroke” and contrasts it with earlier guidance on “aborted myocardial infarction.” It is relevant for coders, CDI professionals, and compliance staff who need to understand how the documentation and clinical picture affect diagnosis assignment in ICD-9-CM-era guidance. The article also references the role of medical review and the Editorial Advisory Board in interpreting these cases.
Why This Topic Matters
Terms such as aborted or averted events can appear similar in documentation, but the coding implications depend on the underlying clinical reality. This article helps readers understand why similar-sounding situations may be treated differently in Coding Clinic guidance and why careful review of the record matters.
What You Will Learn
- How Coding Clinic addressed the concept of an aborted stroke in relation to ICD-9-CM guidance.
- How the article contrasts stroke-related guidance with earlier myocardial infarction guidance.
- How clinical review and documentation influence diagnosis assignment for events described as averted or aborted.
- intended_audiences":["Medical coders","Clinical documentation integrity (CDI) specialists","Coding auditors","Compliance professionals"],"topics":["Coding Clinic guidance","ICD-9-CM diagnosis coding","Stroke documentation","Myocardial infarction documentation","Clinical review"],"medical_specialties":["Neurology","Cardiology"],"code_sets":["ICD-9-CM"],"codes":[{"code_set":"ICD-9-CM","code":"411.1"},{"code_set":"ICD-9-CM","code":"434.91"}],"code_ranges":[],"modifiers":[],"content_type":"Coding Clinic guidance summary","effective_dates":[],"organizations_mentioned":["Central Office on ICD-9-CM","Coding Clinic","Editorial Advisory Board (EAB)"],"keywords":["aborted stroke","aborted myocardial infarction","tPA","cerebral infarction","intermediate coronary syndrome"],"questions_answered":["How does Coding Clinic distinguish an aborted stroke from an aborted myocardial infarction?","What ICD-9-CM guidance is referenced for aborted stroke documentation?","What role does medical review play in assigning the diagnosis in these cases?"],"access_description":"Premium article summarizing Coding Clinic guidance on ICD-9-CM diagnosis assignment for an aborted stroke scenario and related terminology.","disclosure_check":{"contains_code_descriptions":false,"contains_modifier_descriptions":false,"contains_actionable_coding_instructions":false,"contains_article_conclusions":false,"contains_detailed_examples":false}}}]} iciency to 2001, pages 7-8, regarding ‘aborted myocardial infarction (MI),’ these cases are clinically different. In terms of the aborted MI, the patient presented with severe chest pain resembling an acute MI. After tissue plasminogen activator (tPA) was administered, the MI was averted with no evidence of injury to the myocardium. Code 411.1, Intermediate coronary syndrome, was assigned for the aborted MI. Conversely, “aborted stroke,” is a distinct clinical situation. Although the patient received tPA, he still suffered a cerebral infarction, and evidence of the infarction (i.e., brain damage) would be visible microscopically. Therefore, based on the documentation and further medical review, it was the consensus of the clinicians on the Editorial Advisory Board (EAB) for Coding Clinic, that patients who present with symptoms of an acute cerebral infarction and receive tPA have actually had an infarct. Assign code 434.91, Cerebral artery occlusion, with cerebral infarction. Selection of the correct code assignment for a condition described as averted or aborted depends on whether the condition actually occurred.
Who Should Read This
- Medical coders
- Clinical documentation integrity (CDI) specialists
- Coding auditors
- Compliance professionals
Codes Discussed
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