2025 ICD-10-CM code I21
(Valid) Effective Date: N/A Revision Date: N/A Diseases of the circulatory system - Ischemic heart diseases 9 Feed
Acute myocardial infarction (heart attack). This includes cardiac infarction due to coronary artery embolism, occlusion, rupture, or thrombosis.
Medical necessity for I21 is established by the presence of signs and symptoms consistent with acute myocardial infarction, supported by objective findings such as ECG changes and elevated cardiac biomarkers. The medical record should clearly document the clinical rationale for the diagnostic and therapeutic interventions provided.
Physicians who diagnose and treat acute myocardial infarction have the clinical responsibility to accurately document the patient's presentation, including symptoms, ECG findings, and laboratory results. They are also responsible for initiating appropriate treatment, which may include medications, percutaneous coronary intervention (PCI), or thrombolytic therapy.
In simple words: A heart attack, known medically as an acute myocardial infarction, occurs when blood flow to part of the heart is blocked, usually by a blood clot.This blockage can damage or destroy heart muscle.
Acute myocardial infarction. Includes: cardiac infarction, coronary (artery) embolism, coronary (artery) occlusion, coronary (artery) rupture, coronary (artery) thrombosis, infarction of heart, myocardium, or ventricle, myocardial infarction specified as acute or with a stated duration of 4 weeks (28 days) or less from onset. Use additional code, if applicable, to identify: exposure to environmental tobacco smoke (Z77.22), history of tobacco dependence (Z87.891), occupational exposure to environmental tobacco smoke (Z57.31), status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility (Z92.82), tobacco dependence (F17.-), tobacco use (Z72.0). Excludes2: old myocardial infarction (I25.2), postmyocardial infarction syndrome (I24.1), subsequent type 1 myocardial infarction (I22.-)
Example 1: A 65-year-old male presents to the emergency department with chest pain radiating to his left arm, shortness of breath, and diaphoresis.An ECG shows ST-segment elevation, and cardiac biomarkers are elevated, confirming the diagnosis of an acute myocardial infarction.The patient undergoes emergent PCI., A 50-year-old female with a history of diabetes and hypertension experiences sudden onset of severe chest pain.She is diagnosed with an acute myocardial infarction based on ECG findings and elevated cardiac biomarkers.She is treated medically with thrombolytic therapy., A 70-year-old male with a history of coronary artery disease is admitted to the hospital with worsening angina.He subsequently develops an acute myocardial infarction, confirmed by ECG and cardiac biomarkers.He undergoes coronary artery bypass grafting (CABG).
Documentation for I21 should include the type of myocardial infarction (STEMI or NSTEMI), the location of the infarction, and any associated complications.Supporting documentation may include ECG findings, cardiac biomarker levels, imaging studies (e.g., echocardiogram, cardiac MRI), and procedural reports (e.g., PCI, CABG).
- Specialties:Cardiology, Emergency Medicine, Internal Medicine, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Emergency Room - Hospital