Cardiology Coding Alert

ICD-10 offers more specific options than ICD-9 for myocardial infarction sequelae.

Trading ICD-9’s myocardial infarction (MI) sequelae code 429.79 for ICD-10 options involves adjusting to reporting codes for specific complications and keeping in mind the time frames each code set applies to acute myocardial infarctions.

ICD-9-CM Code

• 429.79, Certain sequelae of myocardial infarction not elsewhere classified, other

ICD-10-CM Code

• I23.0, Hemopericardium as current complication following acute myocardial infarction
• I23.3, Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction
• I23.6, Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction
• I23.7, Postinfarction angina
• I23.8, Other current complications following acute myocardial infarction

Sequelae of myocardial infarction are complications resulting from the myocardial infarction.

ICD-9 coding rules: Subcategory 429.7x (Certain sequelae of myocardial infarction not elsewhere classified) has a rule to use an additional code to identify the associated myocardial infarction. You choose the additional code from 410.00-410.92 with onset of 8 weeks or less and 414.8 with onset of more than 8 weeks.

Code 429.79 is appropriate for sequelae that don’t have a more specific code, including “mural thrombus (atrial) (ventricular) acquired, following myocardial infarction,” according to a note with the code.

ICD-10 changes: ICD-10 offers unique codes for more complications than ICD-9 does, including hemopericardium (blood in the pericardial sac), cardiac wall rupture without hemopericardium, cardiac thrombosis, and postinfarction angina.

Documentation: Note that I23.- (Certain current complications following ST elevation [STEMI] and non-ST elevation [NSTEMI] myocardial infarction [within the 28 day period]) applies to current complications within 28 days of the AMI. Providers should be sure to document the date of the AMI.

Coder tips: Both I23.0 and I23.6 have Excludes1 notes pointing you elsewhere for conditions if “not specified as current complication following acute myocardial infarction.” Instead of I23.0, you would use I31.2 (Hemopericardium, not elsewhere classified), and instead of I23.6, you would use I51.3 (Intracardiac thrombosis, not elsewhere classified).

Remember: Oct. 1, 2015, is the implementation date for ICD-10. You should apply the code set and official guidelines in effect for the date of service reported. Learn more at  www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.