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ICD-10 Guide
ICD-10 CodesI22.8

I22.8

Billable

Subsequent ST elevation (STEMI) myocardial infarction of other sites

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I22.8 is a billable code used to indicate a diagnosis of subsequent st elevation (stemi) myocardial infarction of other sites.

Key Diagnostic Point:

I22.8 refers to subsequent ST elevation myocardial infarction (STEMI) occurring in sites other than the initial infarction site. This condition is characterized by the reoccurrence of myocardial ischemia and necrosis due to prolonged occlusion of coronary arteries, leading to elevated ST segments on an electrocardiogram (ECG). The clinical presentation may include chest pain, shortness of breath, and other symptoms of acute coronary syndrome. The anatomy involved typically includes the coronary arteries supplying blood to the heart muscle, with the right coronary artery, left anterior descending artery, and circumflex artery being the most commonly affected. Disease progression can vary, with factors such as the extent of coronary artery disease, patient comorbidities, and timely intervention playing critical roles. Diagnostic considerations include ECG changes, cardiac biomarkers (such as troponins), and imaging studies to assess myocardial viability. It is essential for healthcare providers to differentiate between initial and subsequent myocardial infarctions to ensure appropriate management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires accurate interpretation of ECG and biomarker results.
  • Treatment complexity: May involve advanced interventions such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and differentiate from other myocardial infarctions.
  • Coding specificity: Requires precise coding to indicate the site of the subsequent infarction.

Audit Risk Factors

  • Common coding errors: Misclassification of subsequent infarctions as initial events.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history of myocardial infarction.
  • Billing challenges: Denials may occur if the rationale for the subsequent STEMI is not clearly documented.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Emergency Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I22.8 lies in its association with increased morbidity and mortality in patients with recurrent myocardial infarctions. Understanding the epidemiology of subsequent STEMIs can inform population health strategies aimed at reducing cardiovascular disease burden. Quality measures related to timely intervention and management of myocardial infarction can improve healthcare utilization patterns and ultimately enhance patient outcomes.

ICD-9 vs ICD-10

The clinical significance of I22.8 lies in its association with increased morbidity and mortality in patients with recurrent myocardial infarctions. Understanding the epidemiology of subsequent STEMIs can inform population health strategies aimed at reducing cardiovascular disease burden. Quality measures related to timely intervention and management of myocardial infarction can improve healthcare utilization patterns and ultimately enhance patient outcomes.

Reimbursement & Billing Impact

The clinical significance of I22.8 lies in its association with increased morbidity and mortality in patients with recurrent myocardial infarctions. Understanding the epidemiology of subsequent STEMIs can inform population health strategies aimed at reducing cardiovascular disease burden. Quality measures related to timely intervention and management of myocardial infarction can improve healthcare utilization patterns and ultimately enhance patient outcomes.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I22.8?

I22.8 covers subsequent ST elevation myocardial infarctions occurring in different sites from the initial infarction. This includes cases where a patient has a history of myocardial infarction and presents with new ST elevation changes indicative of a new ischemic event.

When should I22.8 be used instead of related codes?

I22.8 should be used when a patient has a documented history of a prior ST elevation myocardial infarction and presents with new symptoms and ECG findings consistent with a subsequent event, ensuring clear differentiation from initial infarction codes.

What documentation supports I22.8?

Documentation should include a detailed history of the patient's previous myocardial infarction, current symptoms, ECG findings showing ST elevation, and laboratory results indicating elevated cardiac biomarkers. Clear clinical notes are essential to support the diagnosis.