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ICD-10 Guide
ICD-10 CodesChapter 9: Diseases of the circulatory systemI23

I23

Non-billable

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

Chapter 9:Diseases of the circulatory system

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

Code Description

ICD-10 I23 is a used to indicate a diagnosis of certain current complications following st elevation (stemi) and non-st elevation (nstemi) myocardial infarction (within the 28 day period).

Key Diagnostic Point:

I23 codes represent certain current complications following ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (MI) that occur within the 28-day period post-event. These complications can include conditions such as myocardial rupture, ventricular septal defect, papillary muscle rupture, and other acute cardiac events. The clinical presentation may vary from chest pain and dyspnea to signs of heart failure or shock, depending on the specific complication. The anatomy involved primarily includes the heart, particularly the myocardium, coronary arteries, and associated structures. Disease progression can lead to severe outcomes if not promptly recognized and treated, as these complications can significantly increase morbidity and mortality rates. Diagnostic considerations include a thorough clinical evaluation, electrocardiograms (ECGs), echocardiography, and cardiac biomarkers to assess the extent of myocardial damage and identify specific complications. Timely intervention is critical to manage these complications effectively and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of complications or failure to document the timing of the MI.
  • Documentation gaps may arise if the clinical notes do not clearly outline the complications or their relationship to the MI.
  • Billing challenges often stem from insufficient evidence of the complication's impact on treatment and outcomes.

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 CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

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 I23 lies in its association with increased morbidity and mortality following myocardial infarction. Understanding these complications is crucial for improving patient outcomes and reducing healthcare costs. Population health impact includes the need for effective management strategies to address the high incidence of complications in post-MI patients. Quality measures may focus on timely diagnosis and treatment of these complications, influencing healthcare utilization patterns and overall patient care.

ICD-9 vs ICD-10

The clinical significance of I23 lies in its association with increased morbidity and mortality following myocardial infarction. Understanding these complications is crucial for improving patient outcomes and reducing healthcare costs. Population health impact includes the need for effective management strategies to address the high incidence of complications in post-MI patients. Quality measures may focus on timely diagnosis and treatment of these complications, influencing healthcare utilization patterns and overall patient care.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the complications and the associated treatment provided. Common denials may occur if documentation does not sufficiently link the complications to the MI or if the coding lacks specificity. Best practices include ensuring that all clinical notes are detailed and that the coding accurately reflects the patient's condition and treatment plan.

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 I23?

I23 covers specific complications such as myocardial rupture, ventricular septal defect, and papillary muscle rupture that arise within 28 days following a STEMI or NSTEMI. Each condition has distinct diagnostic criteria and clinical implications.

When should I23 be used instead of related codes?

I23 should be used when a patient presents with complications directly related to a recent myocardial infarction within the specified time frame. It is crucial to differentiate these complications from other cardiac conditions that may not be directly linked to an MI.

What documentation supports I23?

Documentation must include clear evidence of the myocardial infarction, the specific complication(s) that developed, and the clinical management provided. This includes diagnostic tests, treatment plans, and follow-up evaluations.