AHA Coding Clinic® for ICD-9 - 2004 Issue 2; Ask the Editor

Acute Coronary Syndrome and Coronary Artery Disease

The patient is a 77-year-old gentleman, who was admitted and treated for acute coronary syndrome. Diagnostic left heart cardiac catheterization showed critical arteriosclerotic coronary artery disease involving the left anterior descending and ostial diagonal. The patient underwent successful angioplasty, stent insertion of the anterior descending and Integrilin infusion. Should acute coronary syndrome or coronary artery disease (CAD) be sequenced as principal diagnosis? Would the CAD be viewed as the underlying cause of the acute coronary syndrome? Although guidelines for unstable angina with CAD have been published, this particular scenario has not been addressed in Coding Clinic. ...

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