Wiki Type 2 MI/Type 2 NSTEMI/Demand ischemia

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
G
Code: I21.4

Code Name: ICD-10 Code for Non-ST elevation (NSTEMI) myocardial infarction

Block: Ischemic heart diseases (I20-I25)

Details: Non-ST elevation (NSTEMI) myocardial infarction
Acute subendocardial myocardial infarction
Non-Q wave myocardial infarction NOS
Nontransmural myocardial infarction NOS
I21

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)

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

Excludes2: old myocardial infarction (I25.2)
postmyocardial infarction syndrome (I24.1)
subsequent myocardial infarction (I22.-)

Guidelines: Diseases of the circulatory system (I00-I99)

Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
systemic connective tissue disorders (M30-M36)
transient cerebral ischemic attacks and related syndromes (G45.-)

For more details on I21.4, ICD-10 Code for Non-ST elevation (NSTEMI) myocardial infarction , visit: https://coder.aapc.com/icd-10-codes/
Messages
18
Best answers
0
Hello,

Please look in to the following scenarios

1) If Physician Documented Type2 MI or Type 2 NSTEMI what will be the code?

2)Tyepe 2 MI or Type 2 NSTEMI Probably Demand ischemia.
 

srinivas.a

Contributor
Messages
10
Best answers
0
Type 2 NSTEMI

Type 2 NSTEMI is coded to I24.8 --- It is an Supply/demand (type 2) mismatch myocardial infarction not a True MI.
 
Messages
3
Best answers
0
Nstemi vs demand ischemia

NSTEMI.jpg

Question:
If a provider documents type 2 myocardial infarction
(T2MI) due to demand ischemia, how should it be
coded?
Answer:
Assign code I21.4, Non-ST elevation (NSTEMI)
myocardial infarction, for a T2MI. Typically, a
type 2 myocardial infarction is marked by non-
ST elevation, and occurs secondary to cardiac
stress due to other causes (i.e., ischemia resulting
from a supply-and-demand mismatch), without
atherosclerotic plaque rupture, but with myocardial
necrosis. Therefore, code a type 2 myocardial
infarction as a NSTEMI, unless otherwise
documented as STEMI.
 
Top