I21.4

I21.4: Non-ST elevation (NSTEMI) myocardial infarction

Billable / specific codeICD-10-CM

I21.4 is a billable, specific ICD-10-CM code for non-st elevation (nstemi) myocardial infarction. It is valid for submission on a claim.

Check I21.4 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Acute subendocardial myocardial infarction
Non-Q wave myocardial infarction NOS
Nontransmural myocardial infarction NOS
Type 1 non-ST elevation myocardial infarction

Excludes2 inherited from the categories above I21.4

Not part of this code, but both may be coded when both are present.

Written on I21: Acute myocardial infarction

old myocardial infarction (I25.2)
postmyocardial infarction syndrome (I24.1)
subsequent type 1 myocardial infarction (I22.-)

Other codes that can never be billed with I21.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

I5ANon-ischemic myocardial injury (non-traumatic)

Risk adjustment

I21.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 228 Acute Myocardial Infarction0.252 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

I21.4 is named in 45 Medicare coverage policies: 45 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52458Automatic External Defibrillators - Policy Article
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A53775Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation
A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

Alphabetic index entries that lead here

Infarct, infarction›nontransmural
Infarct, infarction›subendocardial(acute) (nontransmural)
Necrosis, necrotic›subendocardial(acute)
Infarct, infarction›myocardium, myocardial›non-Q wave
Infarct, infarction›myocardium, myocardial›non-ST elevation(NSTEMI)
Infarct, infarction›myocardium, myocardial›nontransmural

Code history

Unchanged in every release from FY2024 to FY2027.