Myocardial infarction, acute (AMI), NOS

ICD10 Diagnosis
Dx:	Myocardial infarction, acute (AMI), NOS
ICD10 code:	I21.9
Pre-ICD10 counterpart:	Myocardial infarction
Charlson/ALERT Scale:	Myocardial infarction
APACHE Como Component:	none
APACHE Acute Component:	2019-0: Coronary Artery Disease
Start Date:
Stop Date:
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

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  • 2019-01-01
  • 2999-12-31
  • I21.9

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Additional Info

This code is only used for an Acute Myocardial Infarction (AMI) when the more specific type is unknown(i.e. Q-wave, non-Q-wave).

ICD 10 has this code for STEMI: 2024 ICD-10-CM Diagnosis Code I21.3 ST elevation (STEMI) myocardial infarction of unspecified site that includes transmural (Q wave) infarction ICD 10 has this code for NSTEMI: 2024 ICD-10-CM Diagnosis Code I21.4 Non-ST elevation (NSTEMI) myocardial infarction that includes Nontransmural myocardial infarction NOS Would it be less labor intensive for collectors to be able to use these codes instead of MI codes dependent upon development (or not) of Q waves as this is problematic to determine. Thank you, Pamela Piche 07:49, 2024 April 5 (CDT) I have added this to TASK, in 2019 ICD 10 did not have STEMI/NSTEMI codes, now in the 2024 version they do, I agree with Pam can we switch to the new codes? Lisa Kaita 15:10, 2024 April 5 (CDT)

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MI - type vs mechanism

MIs are occasionally listed as "Type 2 MIs", ie no evidence of coronary artery disease (CAD). This refers to the mechanism, and the AMI codes include any/all mechanisms (including coronary artery embolism, thrombosis or thromboembolism); said another way, we don't particularly care about the mechanism. They should be coded based on their manifestation.

In ICD10, this will mean:

• Code the appropriate AMI code:
  • Myocardial infarction (STEMI), acute (AMI), transmural (Q-wave)
  • Myocardial infarction (NSTEMI), acute (AMI), subendocardial/non-transmural (non-Q-wave)
  • Myocardial infarction, acute (AMI), NOS
  • Past history, myocardial infarction (old MI)
• Code the cause separately, as a Combined ICD10 codes. For example it might be one of the following:
  • Coronary artery disease, chronic (atherosclerosis, chronic ischemic heart disease)
  • Ischemic heart disease, acute NOS
  • anemia - Category:Anemia
  • hypovolemia - Dehydration (volume depletion, hypovolemia)
  • Bradycardia

MI - acute vs past history

To decide whether to code an acute MI dx in the Admit Diagnosis or Acquired Diagnosis / Complication, or a Past history, myocardial infarction (old MI) in the Comorbid Diagnosis, consider the following:

• Regarding an MI that occured prior to the current hospitalization -- might be coded as either Comorbid Diagnosis, or a Past history, myocardial infarction (old MI)
• In ICD10 the code for Past history, myocardial infarction (old MI) reads as follows: Healed myocardial infarction -- Past myocardial infarction diagnosed by ECG or other special investigation, but currently presenting no symptoms.
• If the prior MI is still active and we're not dealing with any current complications of it, then instead use one of the AMI codes, as a Comorbid Diagnosis.
• If the prior MI is still active and we are dealing with any current complications of it, then instead use one of the AMI codes, as a Admit Diagnosis.
  • Examples: Papillary muscle rupture or Ongoing angina related to a recent MI prior to this unit/ward admission.
• For a missed MI: code it as one of the "...acute..." codes if the missed MI is being treated as an acute MI

Alternate ICD10s to consider coding instead or in addition

Candidate Combined ICD10 codes

• Also code any acute complications from Myocardial Infarction list.

Related CCI Codes

Data Integrity Checks (automatic list)

none found

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ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results