ICD10monitor December 4, 2023
Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Today I would like to call your attention to Type 2 myocardial infarction (MI), A21.A1, versus demand ischemia, I24.89. I frequently see denials associated with these two diagnosis codes due to conflicting documentation.

There is an Index entry under “Ischemia, demand, with myocardial infarction,” which is assigned to A21.A1. If the documentation is conflicting, you will need to query the provider regarding the establishment of the myocardial infarction.

The confirmation of the MI changes the code from I24.89 to I21.A1. Another reason to establish Type 2 MI is that demand ischemia is classified as a complication or comorbidity (CC) and Type 2 MI is a major CC (MCC). If you assign a single MCC to a case, then there is...

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