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I22 ICD-10-CM Code: Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction

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Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
11 inclusion terms · 2 Excludes1 · 7 use-additional codes · 1 code-also instruction

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code, if applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)

+3 more in Instructions

Excludes1Never report with this code
  • subsequent myocardial infarction, type 2 (I21.A1)
  • subsequent myocardial infarction of other type (type 3) (type 4) (type 5) (I21.A9)
Code alsoMay be needed with this code
  • the presence of hypertension (I10-I1A)
IncludesWhat this code covers
  • acute myocardial infarction occurring within four weeks (28 days) of a previous acute myocardial infarction, regardless of site
  • cardiac infarction
  • coronary (artery) embolism
  • coronary (artery) occlusion

+7 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I22 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on I22 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • acute myocardial infarction occurring within four weeks (28 days) of a previous acute myocardial infarction, regardless of site
  • cardiac infarction
  • coronary (artery) embolism
  • coronary (artery) occlusion
  • coronary (artery) rupture
  • coronary (artery) thrombosis
  • infarction of heart, myocardium, or ventricle
  • recurrent myocardial infarction
  • reinfarction of myocardium
  • rupture of heart, myocardium, or ventricle
  • subsequent type 1 myocardial infarction

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Code Also

Additional codes that may be required to fully describe the encounter.

  • the presence of hypertension (I10-I1A)

Source: inherited from I20-I25

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility (Z92.82)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Coder workflow for I22

MedCoder structured workflow — derived from this code’s own official record

Before you code I22

  1. I22 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewI22.0, I22.1, I22.2, I22.8, I22.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I22. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath I22?
    Yes → Select that code and continue the checks below on its own page.
    No → I22 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewI22.0, I22.1, I22.2, I22.8, I22.9

  2. Does the documentation support a condition named in I22’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewI21.A1, I21.A9

Consider I22. Then work the Use Additional Code note and review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting I22(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I22: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareI21.A1, I21.A9

    See the official tabular notes · Guidelines I.A.12.a

  • Use Additional Code — after identifying I22(7 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I22 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewZ77.22, Z87.891, Z57.31, Z92.82, F17, Z72.0

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition I22 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewI21.A1, I21.A9

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with I22?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewZ77.22, Z87.891, Z57.31, Z92.82, F17, Z72.0

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse I22 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of I22 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • I21.A1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of subsequent myocardial infarction, type 2 moves the case to I21.A1; the two are not reported together unless documented as unrelated.

    Full comparison: I22 vs I21.A1 →

  • I21.A9— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of subsequent myocardial infarction of other type (type 3) (type 4) (type 5) moves the case to I21.A9; the two are not reported together unless documented as unrelated.

    Full comparison: I22 vs I21.A9 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction is a non-billable ICD-10-CM category code (I22). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

4) Subsequent acute myocardial infarction A code from category I22, Subsequent ST elevation (STEMI) and non- ST elevation (NSTEMI) myocardial infarction, is to be used when a patient who has suffered a type 1 or unspecified AMI has a new AMI within the 4 week time frame of the initial AMI. A code from category I22 must be used in conjunction with a code from category I21. The sequencing of the I22 and I21 codes depends on the circumstances of the encounter.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

Do not assign code I22 for subsequent myocardial infarctions other than type 1 or unspecified. For subsequent type 2 AMI assign only code I21.A1. For subsequent type 4 or type 5 AMI, assign only code I21.A9.

Chapter 9: Diseases of the Circulatory System (I00 -I99)

If a subsequent myocardial infarction of one type occurs within 4 weeks of a myocardial infarction of a different type, assign the appropriate codes from category I21 to identify each type. Do not assign a code from I22. Codes from category I22 should only be assigned if both the initial and subsequent myocardial infarctions are type 1 or unspecified.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 7 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name I22 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: I25.82 — Chronic total occlusion of coronary artery.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Excludes2 notes: I21 — Acute myocardial infarction, I74 — Arterial embolism and thrombosis, I82 — Other venous embolism and thrombosis.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: Z92.82 — Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Contextual Map

Every relationship of I22 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I22 with these 12 related codes in Claim Check

Hierarchy

Excludes1

Use Additional Code

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Relevant guides

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can I22 be billed directly?

No. I22 (Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I22 — Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i22-subsequent-st-elevation-stemi-and-non-st-elevation-nstemi-myocardial-infarction

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I22 in its code family, with their registry titles.