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2025 ICD-10-CM code I23.1

Atrial septal defect occurring as a direct consequence of an acute myocardial infarction.

Code I23.1 only if the atrial septal defect is a direct consequence of the acute myocardial infarction.Do not code if the atrial septal defect is unrelated to the acute myocardial infarction, or is pre-existing.

The medical necessity for coding I23.1 is established when an atrial septal defect is directly linked to a prior acute myocardial infarction.The presence and severity of the defect must be clinically documented to justify the code.

The clinical responsibility involves the accurate diagnosis of the atrial septal defect, assessment of its severity, and determining the appropriate management strategy, which may include medication, surgery or other interventional procedures.The physician monitors the patient's clinical course and makes adjustments to the management plan as needed.

IMPORTANT:Consider also coding for hypertension (I10-I15) if present.Other complications following acute myocardial infarction are coded using I23.0-I23.9, excluding those explicitly excluded in the guidelines.

In simple words: This code is used when a hole develops between the upper chambers of the heart (atria) after a heart attack. The hole is a direct result of the damage caused by the heart attack.

This ICD-10-CM code classifies an atrial septal defect that arises as a complication following an acute myocardial infarction (heart attack).The atrial septal defect is a direct result of the myocardial infarction and represents a structural abnormality in the heart's atria, caused by the heart attack's damage to the heart tissue.

Example 1: A 65-year-old male presents to the emergency department with chest pain, shortness of breath, and palpitations following an acute myocardial infarction.Echocardiography reveals a new atrial septal defect, directly attributable to the heart attack., A 72-year-old female, post-myocardial infarction, experiences worsening dyspnea. Cardiac catheterization and echocardiography demonstrate an atrial septal defect as a consequence of the recent heart attack.She undergoes cardiac surgery to repair the septal defect., A 58-year-old male with a history of hypertension and hyperlipidemia experiences an acute myocardial infarction.During follow-up, a newly diagnosed atrial septal defect is found to be a late complication of the MI, impacting his overall cardiovascular health.Medical management is chosen in this instance.

Detailed medical history, including the timing of the atrial septal defect relative to the myocardial infarction.Echocardiographic report clearly indicating the presence and characteristics of the atrial septal defect.Cardiac catheterization reports, if performed.Other relevant diagnostic tests such as electrocardiograms.Treatment plan and progress notes.Discharge summary.

** This code is for use when the atrial septal defect is a direct consequence of the myocardial infarction, and not a pre-existing condition or an unrelated finding.Careful clinical correlation is essential.

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