Cardiology Question for the Week of August 28, 2017

Cardiology Compliance Question of the Week


Can you provide any information about the new ICD-10 coding guidelines for MI?


The August 15, 2017 online issue of ICD10monitor includes an article by Erica E. Remer, MD, FACEP, CCDS entitled “Learning ICD-10: Documenting Type 2 Myocardial Infarction” (MI) that provides details about the guidelines for fiscal year (FY) 2018. For this article, go to

The article includes the following information:

  • The new guidelines reflect the “implication that a Type 2 MI is different than a Type 1 MI.”
  • There is now a unique code for Type 2 MI, I21.A1. Remer says, “It does not need artery site specification because that is not relevant. Its significance is that it imparts a more serious prognosis to the causative underlying condition.“
  • Guideline I.C.9.e.5 specifies that “MI due to demand ischemia or secondary to ischemic (im)balance is assigned to Type 2 MI and not I24.8, Other forms of acute ischemic heart disease.” Accordiing to Remer, coders sometimes disregard the “Type 2 MI” verbiage and only code the “due to demand ischemia” with I24.8, which does not capture the patient’s severity of illness or complexity.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.