Cardiology Coding Alert

Question: The patient had a ST-segment elevation myocardial infarction (STEMI) myocardial infarction (MI) involving the left circumflex coronary artery on May 1. The patient came into the cardiologist’s office for a follow-up appointment to address the patient’s hypertension on June 1, and it’s mentioned that the patient had a STEMI on May 1 that was resolved. Which ICD-10-CM code should I report on my claim?

Answer: In this case, you should report I10 (Essential (primary) hypertension) and I25.2 (Old myocardial infarction) on this claim.

Coding rule: If an old or healed MI does not require further care, you should report code I25.2, according to the ICD-10-CM Official Guidelines for Coding and Reporting.

Don’t miss: When you are coding MIs, it’s really important to read your cardiologist’s medical documentation and learn the age of the MI because you will report different codes based upon this information.

For example, if the MI is equal to or less than four weeks old and it meets ICD-10’s definition of “other diagnoses,” you should report the appropriate code from category I21- (Acute myocardial infarction). This includes “transfers to another acute setting or a postacute setting,” per the guidelines.

On the other hand, if the encounter occurs after the four-week timeline, and the patient is still receiving care related to the MI, you should report the appropriate aftercare code, not a code from category I21-.