Documentation Tip of the Week: Troponemia

Posted on Wed, May 13, 2015
Documentation Tip of the Week: Troponemia

Documentation tips for clinicians

Troponemia is a lab finding and is not a diagnosis. This lab finding is not benign. Surgical data demonstrates increased 30, 60 and 90 day mortality with elevated troponin associated with surgical procedures.
Documentation suggestions:

1) Not clinically relevant

  • Chronic Kidney Disease may be associated with elevation of troponin beyond the upper limits of normal, but the troponin level should remain relatively stable through the hospitalization.
  • If the troponin level increases or decreases through the hospitalization consider

2) Demand Ischemia
  • Does not code to an acute MI. Demand ischemia is due to supply demand mismatch.

3) NSTEMI type 2
  • This codes to an acute MI from a coding perspective.
  • Type 2 NSTEMI is also due to supply demand mismatch.
  • Associated with higher severity of illness 
  • Quality metrics tracked for AMI

Dr. Timothy Brundage is a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, Fla. Dr. Brundage earned his bachelor’s degree in chemistry and molecular biology at the University of Michigan, his M.D. at the Wayne State University School of Medicine and completed his residency in internal medicine at the University of South Florida College of Medicine. Subscribe to Dr. Brundage’s weekly documentation tips, or ask him about specific documentation issues, by emailing him at

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