Ischemic heart diseases I20-I25

Ischemic heart diseases I20-I25

Code Also

  • the presence of hypertension (I10-I1A )

Codes

I20  Angina pectoris

Use Additional

  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Type 1 Excludes

  • angina pectoris with atherosclerotic heart disease of native coronary arteries (I25.1-)
  • atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris (I25.7-)
  • postinfarction angina (I23.7)

Clinical Information

  • A disorder characterized by substernal discomfort due to insufficient myocardial oxygenation.
  • A heart condition marked by paroxysms of chest pain due to reduced oxygen to the heart.
  • Angina is chest pain or discomfort you get when your heart muscle does not get enough blood. It may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw or back. Angina is a symptom of coronary artery disease (cad), the most common heart disease. Cad happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.there are three types of angina: stable, unstable and variant. Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It does not go away with rest or medicine. It is a sign that you could have a heart attack soon.not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.
  • Chest pain caused by coronary heart disease
  • Previous or current symptoms described as chest pain or pressure, jaw pain, arm pain, or other equivalent discomfort suggestive of cardiac ischemia. (nih roadmap cardiovascular data standards working group)
  • Recurring thoracic pain or discomfort which occurs when a part of the heart does not receive enough blood; usually caused by exertion or excitement.
  • The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed that supplied by the coronary circulation.

Codes

  • I20 Angina pectoris
    •  I20.0 Unstable angina
    •  I20.1 Angina pectoris with documented spasm
    •  I20.2 Refractory angina pectoris
    • I20.8 Other forms of angina pectoris
      •  I20.81 Angina pectoris with coronary microvascular dysfunction
      •  I20.89 Other forms of angina pectoris
    •  I20.9 Angina pectoris, unspecified

I21  Acute myocardial infarction

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

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.

Codes

  • I21 Acute myocardial infarction
    • I21.0 ST elevation (STEMI) myocardial infarction of anterior wall
      •  I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery
      •  I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
      •  I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
    • I21.1 ST elevation (STEMI) myocardial infarction of inferior wall
      •  I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery
      •  I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
    • I21.2 ST elevation (STEMI) myocardial infarction of other sites
      •  I21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
      •  I21.29 ST elevation (STEMI) myocardial infarction involving other sites
    •  I21.3 ST elevation (STEMI) myocardial infarction of unspecified site
    •  I21.4 Non-ST elevation (NSTEMI) myocardial infarction
    •  I21.9 Acute myocardial infarction, unspecified
    • I21.A Other type of myocardial infarction
      •  I21.A1 Myocardial infarction type 2
      •  I21.A9 Other myocardial infarction type
    •  I21.B Myocardial infarction with coronary microvascular dysfunction

I22  Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction

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 1 Excludes

  • subsequent myocardial infarction, type 2 (I21.A1)
  • subsequent myocardial infarction of other type (type 3) (type 4) (type 5) (I21.A9)

Includes

  • acute myocardial infarction occurring within four weeks (28 days) of a previous acute myocardial infarction, regardless of site
  • cardiac infarction
  • coronary (artery) embolism
  • coronary (artery) occlusion
  • coronary (artery) rupture
  • coronary (artery) thrombosis
  • infarction of heart, myocardium, or ventricle
  • recurrent myocardial infarction
  • reinfarction of myocardium
  • rupture of heart, myocardium, or ventricle
  • subsequent type 1 myocardial infarction

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).

Codes

  • I22 Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
    •  I22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
    •  I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
    •  I22.2 Subsequent non-ST elevation (NSTEMI) myocardial infarction
    •  I22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sites
    •  I22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site

I23  Certain current complications following ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (within the 28 day period)

Codes

  • I23 Certain current complications following ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (within the 28 day period)
    •  I23.0 Hemopericardium as current complication following acute myocardial infarction
    •  I23.1 Atrial septal defect as current complication following acute myocardial infarction
    •  I23.2 Ventricular septal defect as current complication following acute myocardial infarction
    •  I23.3 Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction
    •  I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction
    •  I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction
    •  I23.6 Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction
    •  I23.7 Postinfarction angina
    •  I23.8 Other current complications following acute myocardial infarction

I24  Other acute ischemic heart diseases

Type 1 Excludes

  • angina pectoris (I20.-)
  • transient myocardial ischemia in newborn (P29.4)

Type 2 Excludes

  • non-ischemic myocardial injury (I5A)

Codes

  • I24 Other acute ischemic heart diseases
    •  I24.0 Acute coronary thrombosis not resulting in myocardial infarction
    •  I24.1 Dressler’s syndrome
    • I24.8 Other forms of acute ischemic heart disease
      •  I24.81 Acute coronary microvascular dysfunction
      •  I24.89 Other forms of acute ischemic heart disease
    •  I24.9 Acute ischemic heart disease, unspecified

I25  Chronic ischemic heart disease

Use Additional

  • code to identify:
  • chronic total occlusion of coronary artery (I25.82)
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Type 2 Excludes

  • non-ischemic myocardial injury (I5A)

Codes

  • I25 Chronic ischemic heart disease
    • I25.1 Atherosclerotic heart disease of native coronary artery
      •  I25.10 …… without angina pectoris
      • I25.11 Atherosclerotic heart disease of native coronary artery with angina pectoris
        •  I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
        •  I25.111 …… with documented spasm
        •  I25.112 Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
        •  I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
        •  I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
    •  I25.2 Old myocardial infarction
    •  I25.3 Aneurysm of heart
    • I25.4 Coronary artery aneurysm and dissection
      •  I25.41 Coronary artery aneurysm
      •  I25.42 Coronary artery dissection
    •  I25.5 Ischemic cardiomyopathy
    •  I25.6 Silent myocardial ischemia
    • I25.7 Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris
      • I25.70 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris
        •  I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
        •  I25.701 …… with documented spasm
        •  I25.702 Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris
        •  I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
        •  I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
      • I25.71 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris
        •  I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
        •  I25.711 …… with documented spasm
        •  I25.712 Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris
        •  I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
        •  I25.719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
      • I25.72 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris
        •  I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
        •  I25.721 …… with documented spasm
        •  I25.722 Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris
        •  I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
        •  I25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
      • I25.73 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris
        •  I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
        •  I25.731 …… with documented spasm
        •  I25.732 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris
        •  I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
        •  I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
      • I25.75 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris
        •  I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina
        •  I25.751 …… with documented spasm
        •  I25.752 Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris
        •  I25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
        •  I25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
      • I25.76 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris
        •  I25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
        •  I25.761 …… with documented spasm
        •  I25.762 Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris
        •  I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
        •  I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
      • I25.79 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris
        •  I25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
        •  I25.791 …… with documented spasm
        •  I25.792 Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris
        •  I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
        •  I25.799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
    • I25.8 Other forms of chronic ischemic heart disease
      • I25.81 Atherosclerosis of other coronary vessels without angina pectoris
        •  I25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
        •  I25.811 Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
        •  I25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
      •  I25.82 Chronic total occlusion of coronary artery
      •  I25.83 Coronary atherosclerosis due to lipid rich plaque
      •  I25.84 Coronary atherosclerosis due to calcified coronary lesion
      •  I25.85 Chronic coronary microvascular dysfunction
      •  I25.89 Other forms of chronic ischemic heart disease
    •  I25.9 Chronic ischemic heart disease, unspecified
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