Choose I25.2 for a Healed Heart Attack
Question: The patient’s medical history shows a myocardial infarction several years ago. The physician notes no current symptoms or ongoing care for the infarction. Should we report a personal history code, or is there a specific ICD-10-CM code for the prior heart attack? Maine Subscriber Answer: For outpatient coding, report I25.2 (Old myocardial infarction) when the documentation supports an old or healed myocardial infarction for which no further acute care is required. There is a personal history code, Z86.79 (Personal history of other diseases of the circulatory system), but it’s not as specific as 125.2. However, you should report I25.2 only when the old infarction is clinically relevant to the encounter and meets the applicable reporting guidelines. But what qualifies as prior or old? ICD-10-CM classifies a myocardial infarction as acute for 4 weeks (28 days) from onset. During that period, assign the appropriate acute myocardial infarction code from category I21.- (Acute myocardial infarction), or an I22.- (Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction) code when the documentation supports a subsequent myocardial infarction. For a patient whose infarction is more than 4 weeks old and is no longer requiring acute care, you can report I25.2 — provided that the documentation supports an old or healed myocardial infarction. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
