2025 ICD-10-CM Diagnosis Code I21

Acute myocardial infarction

  • I21 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2025 edition of ICD-10-CM I21 became effective on October 1, 2024.
  • This is the American ICD-10-CM version of I21 – other international versions of ICD-10 I21 may differ.

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)

Type 2 Excludes

  • old myocardial infarction (I25.2)
  • postmyocardial infarction syndrome (I24.1)
  • subsequent type 1 myocardial infarction (I22.-)

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

The following code(s) above I21 contain annotation back-references

 that may be applicable to I21:

  • I00-I99  Diseases of the circulatory system
  • I20-I25  Ischemic heart diseases

Clinical Information

  • A disorder characterized by gross necrosis of the myocardium; this is due to an interruption of blood supply to the area.
  • Coagulation of blood in any of the coronary vessels. The presence of a blood clot (thrombus) often leads to myocardial infarction.
  • Complete blockage of blood flow through one of the coronary arteries, usually from coronary atherosclerosis.
  • Each year over a million people in the United States Have a heart attack. About half of them die. Many people have permanent heart damage or die because they don’t get help immediately. It’s important to know the symptoms of a heart attack and call 9-1-1 if someone is having them. Those symptoms include
    • chest discomfort – pressure, squeezing, or pain
    • shortness of breath
    • discomfort in the upper body – arms, shoulder, neck, back
    • nausea, vomiting, dizziness, lightheadedness, sweating
    these symptoms can sometimes be different in women.what exactly is a heart attack? most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat – called an arrhythmia – that causes a severe decrease in the pumping function of the heart. A blockage that is not treated within a few hours causes the affected heart muscle to die.
  • Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area, as in coronary thrombosis.
  • Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area.
  • Necrosis of the myocardium caused by an obstruction of the blood supply to the heart (coronary circulation).
  • Necrosis of the myocardium, as a result of interruption of the blood supply to the area. It is characterized by a severe and rapid onset of symptoms that may include chest pain, often radiating to the left arm and left side of the neck, dyspnea, sweating, and palpitations.

Code History

  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): Revised code
    • New description: Acute myocardial infarction
    • 2017 description: ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
  • 2022 (effective 10/1/2021): No change
  • 2023 (effective 10/1/2022): No change
  • 2024 (effective 10/1/2023): No change
  • 2025 (effective 10/1/2024): No change

Code annotations containing back-references to I21:

  • Code First: Z92.82
  • Type 1 Excludes: I5A
  • Use Additional: I16.1
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