Leave I21.0- to I21.4 for type 1 AMIs. For types 3 to 5 (I21.A9), the OGs instruct you to follow the ICD-10 “code also” note for complications and “code first” notes when a postprocedural MI code applies. Bottom line: Everyone who submits MI claims needs to thoroughly review the 2018 OGs.
Provider documentation will need to specify MI type to assist with choosing the most accurate code. The changes start with ICD-10-CM 2018 adding notes under the following subcategories and codes to clarify that they apply to type 1 MIs, which are spontaneous MIs:
Non-ST elevation (NSTEMI) myocardial infarction. I21.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM I21.4 became effective on October 1, 2020.
Z95.810 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z95.810 became effective on October 1, 2021. This is the American ICD-10-CM version of Z95.810 - other international versions of ICD-10 Z95.810 may differ. Z codes represent reasons for encounters.
9.
An acute MI should be reported for up to 4 weeks (28 days) with a code from category I21. Encounters for care related to the MI after the 4‐week timeframe should be coded with the appropriate aftercare code. An old or healed MI, not requiring further care, should be coded as I25. 2, Old Myocardial Infarction.
0 Subsequent myocardial infarction of anterior wall. Subsequent infarction (acute)(of):
BA41. Z Acute myocardial infarction, unspecified - ICD-11 MMS.
Inferior wall myocardial infarction (MI) occurs from a coronary artery occlusion with resultant decreased perfusion to that region of the myocardium. Unless there is timely treatment, this results in myocardial ischemia followed by infarction.
Type 1: Spontaneous MI caused by ischemia due to a primary coronary event (eg, plaque rupture, erosion, or fissuring; coronary dissection) Type 2: Ischemia due to increased oxygen demand (eg, hypertension), or decreased supply (eg, coronary artery spasm or embolism, arrhythmia, hypotension)
410.21 - Acute myocardial infarction of inferolateral wall, initial episode of care.
ICD-Code I10 is a billable ICD-10 code used for healthcare diagnosis reimbursement of Essential (Primary) Hypertension. Its corresponding ICD-9 code is 401.
29.
Acute myocardial infarction, unspecified 1 I21.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2021 edition of ICD-10-CM I21.9 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of I21.9 - other international versions of ICD-10 I21.9 may differ.
tobacco use ( Z72.0) Acute myocardial infarction. Clinical Information. Necrosis of the myocardium, as a result of interruption of the blood supply to the area. It is characterized by a severe and rapid onset of symptoms that may include chest pain, often radiating to the left arm and left side of the neck, dyspnea, sweating, and palpitations. ...
The 2022 edition of ICD-10-CM I21.9 became effective on October 1, 2021.
Codes. I21 Acute myocardial infarction.
A disorder characterized by gross necrosis of the myocardium; this is due to an interruption of blood supply to the area.
The new code set also will add I21.A1 ( Myocardial infarction type 2 ), which includes MIs due to demand ischemia or ischemic imbalance. For MI types 3, 4a, 4b, 4c, and 5, you’ll use I21.A9 ( Other myocardial infarction type ). Type 3 involves sudden cardiac death, type 4 is PCI-related, and type 5 is CABG-related. Finally, you’ll have new code I21.9 ( Acute myocardial infarction, unspecified) to use when documentation doesn’t support using a more specific code.
The American Hospital Association (AHA), American Health Information Management Association (AHIMA), Centers for Medicare and Medicaid Services (CMS), and National Center for Health Statistics (NCHS) all approve these guidelines, and HIPAA requires adherence to the OGs when assigning ICD-10-CM diagnosis codes.
Another helpful lesson you’ll learn from the new OGs is that if documentation specifies STEMI or NSTEMI for type 2 AMI, you still should report type 2 code I21.A1. Leave I21.0- to I21.4 for type 1 AMIs.
I.C.9.e.5: This text is brand new for 2018 and basically tells you to follow the sequencing guidelines in the official code set when reporting AMI types 2 to 5.
You should not assign I22.- for other types of subsequent AMIs. Use I21.A1 for subsequent type 2 AMI, and use I21.A9 for subsequent type 4 and 5 AMI. (Remember, type 3 AMI involves sudden cardiac death.)
The 2022 edition of ICD-10-CM Z95.810 became effective on October 1, 2021.
Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status
I22.2 is a billable ICD code used to specify a diagnosis of subsequent non-ST elevation (NSTEMI) myocardial infarction. A 'billable code' is detailed enough to be used to specify a medical diagnosis.
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.