Question: In addition to all the questions being submitted around the appropriate use of the ICD10CM dx for STEMI when it can include diagnoses made up to 4 weeks prior to the ED visit, and the issues around initially negative EKG, we would also like to raise concern around the need for the STEMI diagnosis to be documented while in the ED.  Because of the urgency around this diagnosis, patients often leave the ED before the provider is able to document the STEMI diagnosis on the problem list.  The UB04 does not require a date for each diagnosis.  Nor does the date have a significant bearing in the problem list.  Problem list must have a current list of problems. Any date during the stay gives insight to the next care provider; however, if the provider only gets to updating the Problem list say a day after the ED visit then the patient is missed.  Not excluded, missed.  The logic should not be guiding or altering other coding rules or standards for documentation.