A 58-year-old female with class III heart failure with hypertrophic obstructive cardiomyopathy (HOCM) underwent alcohol septal ablation. A total of 1.9 mL of alcohol was delivered to the proximal septum. The provider documented “subendocardial septal myocardial infarction-medically induced/alcohol septal ablation.” Is it appropriate to assign a code for the myocardial infarction?
No, it is not appropriate to assign a code for myocardial infarction. Assign code 425.11, Hypertrophic obstructive cardiomyopathy, for the HOCM as the principal diagnosis. Assign also the appropriate code for the heart failure as an additional diagnosis. Assign code 37.34, Excision or destruction of other lesion or tissue of heart, endovascular approach, for the procedure performed.Alcohol septal ablation is performed to treat HOCM. The intent of the procedure is to reduce the amount of tissue blocking blood flow in the heart. Pure alcohol is injected into a designated area of the heart, destroying the segment of muscle tissue that is interfering with blood flow. Do not assign a code for the description of subendocardial septal myocardial infarction, since inducing a controlled infarction is the intent of the procedure. This is not a usual myocardial infarction, nor a complication of the procedure.