Here is a glimpse of the 2014 ICD-10-CM codes for STEMI and NSTEMI including some tips regarding the guidelines notes and changes.

Tip # 1 – AMI (Acute Myocardial Infarction) is classified by whether it is the initial MI or a subsequent one occurring within 4 weeks.

    Change – In ICD-9 a subsequent episode of care for MI is considered within 8 weeks. In ICD-10 a subsequent episode of care for MI is considered within 4 weeks.

    There are two basic types of MI – transmural and subendocardial.

Tip # 2 – ICD-10 further classifies by site, such as anterolateral wall or true posterior wall

Tip # 3 – MIs can also be classified as either STEMI or NSTEMI

Coding and Documentation Tips for AMI

  • If an AMI is documented as nontransmural or subendocardial, but the site is provided, it is still coded as a subendocardial AMI.
  • If NSTEMI evolves to STEMI, assign the STEMI code.
  • If STEMI converts to NSTEMI due to thrombolytic therapy, it is still coded as STEMI
  • AMI must be identified as initial or subsequent (occurring within the 4 week (28 day) acute phase of the initial MI
  • STEMI of an unspecified site (I21.3) is the default code that is equivalent to the unspecified term AMI

Click here is an example of the ICD-10 codes for STEMI and NSTEMI Myocardial Infarction. This is a small part of the diagnostic coding found in Chapter 9 (Diseases of Circulatory System) of the ICD-10-CM book. The ICD-10-CM book is more thorough with “Use additional codes, Include, and Exclude codes”.

Click here for an example of a “crosswalk” that you can start to compile for your most commonly used codes in the office.

Click here to browse the ICD-10-CM Coding of ST elevation (STEMI) and non-ST elevation (NSTEMI) Myocardial infarction (MI) tips archive.


References

ICD-10-CM – The Complete Official Draft Code Set; Ingenix
Advanced Anatomy and Physiology for ICD-10-CM/PCS; AMA
2014 Cardiology Top 50 Codes; AAPC

http://apps.who.int/classifications/icd10/browse/2010/en ; WHO website

http://www.aapc.com/ICD-10/codes/index.aspx ; AAPC ICD-10 Code Translator