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I25.2
ICD-10-CM
History of NSTEMI

Find comprehensive information on the diagnosis history of NSTEMI (Non-ST-Elevation Myocardial Infarction). Learn about clinical documentation requirements, medical coding guidelines for NSTEMI, and best practices for healthcare professionals. Explore resources covering NSTEMI diagnosis criteria, troponin levels, ECG changes, and risk stratification. Improve your understanding of NSTEMI management, treatment options, and long-term prognosis. This resource offers valuable insights for physicians, nurses, coders, and other healthcare providers involved in the care of patients with NSTEMI.

Also known as

Non-ST Elevation Myocardial Infarction History
Past NSTEMI
Previous NSTEMI

Diagnosis Snapshot

Key Facts
  • Definition : Prior heart attack due to a partially blocked artery, causing reduced blood flow to the heart.
  • Clinical Signs : Chest pain or discomfort, shortness of breath, nausea, lightheadedness, abnormal EKG.
  • Common Settings : Emergency Room, Cardiology Clinic, Cardiac Catheterization Lab

Related ICD-10 Code Ranges

Complete code families applicable to AAPC I25.2 Coding
I25.1-

Old myocardial infarction

Previous non-ST elevation myocardial infarction (NSTEMI).

I21.-

Acute myocardial infarction

Includes codes for current NSTEMI if documented as old.

Z86.710

Personal history of MI

Indicates past myocardial infarction, including NSTEMI.

I25.9

Chronic ischemic heart disease

May be applicable if NSTEMI led to chronic heart issues.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the NSTEMI currently acute?

  • Yes

    Do NOT code history of NSTEMI. Code the current acute NSTEMI (e.g., I21.4).

  • No

    Is there documented evidence of prior NSTEMI?

Code Comparison

Related Codes Comparison

When to use each related code

Description
NSTEMI - Non-ST Elevation Myocardial Infarction
Unstable Angina
Myocardial Infarction, unspecified

Documentation Best Practices

Documentation Checklist
  • Document presenting symptoms (chest pain, etc.)
  • ECG findings consistent with NSTEMI (e.g., ST depression)
  • Cardiac enzyme elevation (troponin)
  • Absence of ST-segment elevation on ECG
  • Risk factors for CAD documented (smoking, diabetes)

Coding and Audit Risks

Common Risks
  • Documentation Specificity

    Insufficient documentation to distinguish between unstable angina and NSTEMI, leading to inaccurate coding (I20.0 vs I21.4).

  • Timing and Symptoms

    Incorrect documentation of symptom duration and relief, affecting accurate NSTEMI diagnosis coding and potential DRG assignment.

  • Troponin Interpretation

    Misinterpretation or inadequate documentation of troponin levels, crucial for differentiating NSTEMI from unstable angina, impacting coding accuracy.

Mitigation Tips

Best Practices
  • Document angina characteristics: location, duration, radiation, relieving factors.
  • Correlate ECG findings with troponin levels for accurate diagnosis.
  • Specify symptom onset time for timely intervention coding.
  • Query physician for clarity if documentation lacks ischemic symptoms.
  • Document prior MI, coronary artery disease, and risk factors for accurate coding.

Clinical Decision Support

Checklist
  • 1. Elevated troponin AND ischemic symptoms? Documented time of onset?
  • 2. Ischemic ECG changes (e.g., ST depression, T-wave inversion)?
  • 3. No ST elevation? Ruled out STEMI?
  • 4. Documented risk factors (CAD, HTN, DM, smoking)?
  • 5. Coronary angiography or other imaging planned/performed?

Reimbursement and Quality Metrics

Impact Summary
  • NSTEMI reimbursement hinges on accurate coding (ICD-10 I24.1) and documentation supporting the history diagnosis.
  • Quality metrics: Prior NSTEMI impacts risk scores, influencing AMI and heart failure readmission penalties.
  • Coding validation and physician query processes are crucial for proper NSTEMI history reimbursement.
  • Accurate NSTEMI history capture improves data integrity for population health management and research.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Document troponin rise/fall
  • Code STEMI if criteria met
  • Query physician for clarity
  • NSTEMI: I21.4, unspecified site
  • Check documentation for prior MI

Documentation Templates

Patient presents with a history of non-ST-elevation myocardial infarction (NSTEMI).  The prior NSTEMI event occurred on [Date of Infarction] and was confirmed by elevated cardiac troponin levels in the setting of ischemic symptoms.  Symptoms at the time of the prior event included [List symptoms e.g., chest pain, shortness of breath, nausea, diaphoresis].  Electrocardiogram (ECG) at that time showed [ECG findings, e.g., ST-segment depression, T-wave inversion] without ST-segment elevation.  The patient was treated with [Medications and interventions e.g., aspirin, clopidogrel, heparin, nitrates, beta-blockers, coronary angiography with percutaneous coronary intervention (PCI) or medical management].  Current presenting symptoms are [List current symptoms]. Current medications include [List current medications].  Cardiac risk factors include [List risk factors e.g., hypertension, hyperlipidemia, diabetes mellitus, smoking, family history of coronary artery disease].  Physical examination reveals [Record pertinent findings e.g., heart rate, rhythm, blood pressure, lung sounds].  Assessment: History of NSTEMI, currently presenting with [Current symptoms diagnosis, e.g., stable angina, unstable angina, recurrent chest pain]. Plan:  [Outline the plan, e.g., Obtain ECG, cardiac biomarkers, assess for recurrent ischemia, adjust medications as needed, consider stress testing, referral to cardiology].
History of NSTEMI - AI-Powered ICD-10 Documentation