Letters cussion section, we suggest that therapies to curb atheroma So how should we code myocardial injury? It goes with- progression and induce regression, such as statins, may be a out saying that a separate ICD-10 code for nonischemic myo- potential intervention among those with higher BPV. Further cardial injury would be helpful. Short of that, leaders in the studies are required to evaluate underlying mechanisms and American College of Cardiology have advocated for use of the therapeutic implications of the observed association between term non-MI troponin elevation (nMITE) as a way to clearly dif- BPV, coronary atheroma progression, and adverse cardiovas- ferentiate patients with myocardial injury from patients with cular outcomes. type 1 MI for nonclinical coding personnel. We are in the pro- cess of implementing this recommendation at our institu- Donald Clark III, MD, MPH tion. After all, we agree with the authors’ conclusion that fail- Rishi Puri, MBBS, PhD ure to do so “may have substantial implications for hospital reimbursement under value-based programs.” Author Affiliations: Division of Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson (Clark); Cleveland Clinic Coordinating Andrew E. Levy, MD Center for Clinical Research (C5R), Department of Cardiovascular Medicine, Karen S.
JAMA Cardiology – American Medical Association
Published: Oct 14, 2019
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