When the Code Is Wrong, the Care Suffers: Why MI Misclassification Matters to Virginia Hospitals

Accurate data saves lives. That’s why a recent study published in the Journal of the American College of Cardiology (JACC) should concern every hospital, EMS agency, and quality initiative in Virginia.

Researchers found that up to 60% of heart attacks coded as “Type 1 MI” in hospital billing records were wrong. Many of these patients actually had Type 2 MI or even non-ischemic myocardial injury. These errors weren’t small—they directly impact how hospitals are judged, how care is reimbursed, and what treatments patients receive.

For VHAC and its partners, this matters. We use data to improve systems of care, develop protocols, and measure outcomes. But if that data is flawed at the source, so are the metrics that follow.

Here’s the core issue: Administrative billing codes—used in claims data and quality programs—don’t always match the real diagnosis. And with Medicare and other payers tying dollars to data, misclassification has serious implications.

What can we do?

• Advocate for clinical teams to document MI subtype clearly and consistently

• Promote training for coders and physicians on the Fourth Universal Definition of MI

• Support better integration of clinical documentation and coding workflows

• Push for more accurate data collection in statewide registries and reporting tools

At VHAC, we’re committed to elevating heart care across the Commonwealth. That starts with getting the diagnosis—and the data—right.

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