2025 ICD-10-CM code I21.4
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Ischemic heart diseases - Ischemic heart diseases Diseases of the circulatory system (I00-I99) Feed
Acute subendocardial myocardial infarction, also known as Non-ST elevation myocardial infarction (NSTEMI).
Modifiers may apply depending on the circumstances of the encounter and services provided.
Medical necessity for coding I21.4 is established based on the presence of symptoms consistent with myocardial ischemia, abnormal ECG findings, and elevated cardiac biomarkers indicative of myocardial injury.The decision for intervention (e.g., PCI) is based on the severity of the infarction and clinical presentation.
Diagnosis and treatment of acute myocardial infarction, including ECG interpretation, cardiac enzyme testing, and management of associated symptoms.This may involve administering medications, performing procedures (such as angioplasty or stenting), and monitoring the patient's progress.Ongoing care may be required post-discharge.
In simple words: This code indicates a type of heart attack called a Non-ST elevation myocardial infarction (NSTEMI).It happens when blood flow to part of the heart muscle is reduced, but not completely blocked.This causes damage to the heart but isn't as severe as other types of heart attacks.
I21.4, Acute subendocardial myocardial infarction, is a type of heart attack characterized by the blockage of blood flow to a part of the heart muscle.Unlike ST-elevation myocardial infarction (STEMI), NSTEMI does not show a significant ST-segment elevation on an electrocardiogram (ECG). This indicates partial blockage of a coronary artery, leading to myocardial damage but not complete cessation of blood flow. The infarction is subendocardial, affecting the inner layer of the heart muscle.Additional codes may be necessary to specify the location and extent of the damage. The condition typically presents with chest pain, shortness of breath, and other symptoms.
Example 1: A 65-year-old male presents to the emergency department with chest pain, shortness of breath, and diaphoresis.ECG shows ST-segment depression and T-wave inversions. Cardiac enzyme levels are elevated.The patient is diagnosed with NSTEMI and undergoes coronary angiography, followed by percutaneous coronary intervention (PCI)., A 72-year-old female with a history of hypertension and hyperlipidemia experiences sudden onset of chest discomfort radiating to her left arm.She is admitted to the hospital and diagnosed with NSTEMI after ECG and cardiac enzyme tests.She receives medical management with antiplatelet agents, anticoagulants, and beta-blockers., A 58-year-old male with known coronary artery disease presents to his physician's office complaining of increasing fatigue and intermittent chest tightness.Further investigation reveals an NSTEMI.He is managed medically and referred for cardiac rehabilitation.
Detailed history, including onset and character of symptoms, risk factors, family history of cardiovascular disease.ECG findings, including ST-segment changes and T-wave inversions.Cardiac enzyme levels (troponin, CK-MB).Results of any imaging studies (coronary angiography, echocardiography).Treatment plan, including medications and procedures.Follow-up plan.
** NSTEMI is less life-threatening than STEMI but still requires prompt diagnosis and management to prevent further complications.The prognosis varies depending on the extent of myocardial damage and the presence of other risk factors.Patients with NSTEMI may require ongoing medical management, lifestyle modifications, and cardiac rehabilitation.
- Payment Status: Active
- Specialties:Cardiology, Internal Medicine, Emergency Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital