I25.2 ICD-10-CM Code: Old myocardial infarction
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 2 inclusion terms · 1 Excludes2 · 7 use-additional codes · 1 code-also instruction
- Risk adjustment
- RxHCC V08 category 188
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 302 — ATHEROSCLEROSIS WITH MCC (MDC 05)
- MS-DRG 303 — ATHEROSCLEROSIS WITHOUT MCC (MDC 05)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I25.2 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on I25.2 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Healed myocardial infarction
- Past myocardial infarction diagnosed by ECG or other investigation, but currently presenting no symptoms
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- non-ischemic myocardial injury (I5A) Compare I25.2 vs I5A →
Source: inherited from I25
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 to identify:
- chronic total occlusion of coronary artery (I25.82)
- exposure to environmental tobacco smoke (Z77.22)
- history of tobacco dependence (Z87.891)
- occupational exposure to environmental tobacco smoke (Z57.31)
- tobacco dependence (F17.-)
- tobacco use (Z72.0)
Source: inherited from I25
Coder workflow for I25.2
MedCoder structured workflow — derived from this code’s own official record
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
Excludes2 — not part of I25.2(1 note)
Coding workflow: The conditions named in this note are not included in I25.2. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareI5A
See the official tabular notes · Guidelines I.A.12.b
Use Additional Code — after identifying I25.2(7 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I25.2 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
ReviewI25.82, Z77.22, Z87.891, Z57.31, 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: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with I25.2?
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).
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.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (8)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
- History, personal (of), myocardial infarction (old)
- Infarct, infarction, myocardium, myocardial (acute) (with stated duration of 4 weeks or less), diagnosed on ECG, but presenting no symptoms
- Infarct, infarction, myocardium, myocardial (acute) (with stated duration of 4 weeks or less), healed or old
- Infarct, infarction, myocardium, myocardial (acute) (with stated duration of 4 weeks or less), past (diagnosed on ECG or other investigation, but currently presenting no symptoms)
- Occlusion, occluded, artery, coronary (acute) (thrombotic) (without myocardial infarction), healed or old
- Occlusion, occluded, coronary (artery) (vein) (thrombotic), healed or old
- Oldmyocardial infarction (previous)
- Scar, scarring, myocardium, myocardial
Official Coding Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official 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)
For encounters occurring while the myocardial infarction is equal to, or less than, four weeks old, including transfers to another acute setting or a postacute setting, and the myocardial infarction meets the definition for “other diagnoses” (see Section III, Reporting Additional Diagnoses), codes from category I21 may continue to be reported. For encounters after the 4-week time frame and the patient is still receiving care related to the myocardial infarction, the appropriate aftercare code should be assigned, rather than a code from category I21. For old or healed myocardial infarctions not requiring further care, code I25.2, Old myocardial infarction, may be assigned.
Decision Points
The directives on this code's own record, as a pre-claim checklist.
- 7 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
- 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
- 1 Excludes2 entry — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 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
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
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 structured relationships — computed from published CMS and AHRQ datasets
Other codes that name I25.2 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 4 Excludes2 notes across 2 chapters: I21 — Acute myocardial infarction, I74 — Arterial embolism and thrombosis (via I25.-), I82 — Other venous embolism and thrombosis (via I25.-), Z86.7 — Personal history of diseases of the circulatory system.
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.
Named in the grouper logic of 2 MS-DRGs: DRG 302 (MDC 05), DRG 303 (MDC 05).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):CIR011 — Coronary atherosclerosis and other heart disease (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Coronary atherosclerosis and other heart disease).
I24.8 — Other forms of acute ischemic heart disease, I24.81 — Acute coronary microvascular dysfunction, I24.89 — Other forms of acute ischemic heart disease, I24.9 — Acute ischemic heart disease, unspecified, I25.10 — Atherosclerotic heart disease of native coronary artery without angina pectoris, I25.110 — Atherosclerotic heart disease of native coronary artery with unstable angina pectoris, I25.111 — Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm, I25.112 — Atherosclerotic heart disease of native coronary artery with refractory angina pectoris, I25.118 — Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris, I25.119 — Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris, I25.5 — Ischemic cardiomyopathy, I25.6 — Silent myocardial ischemia, I25.700 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris, I25.701 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm, I25.702 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris, I25.708 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris, I25.709 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris, I25.710 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris, I25.711 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm, I25.712 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris, +47 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Infarct, infarction”, “Occlusion, occluded”; these codes share that main term but sit in a different category of the Tabular List.
I21.9 — Acute myocardial infarction, unspecified (myocardium, myocardial), I21.A1 — Myocardial infarction type 2 (myocardium, myocardial, type 2), I21.A9 — Other myocardial infarction type (myocardium, myocardial, type 4), I21.B — Myocardial infarction with coronary microvascular dysfunction (myocardium, myocardial, with, coronary microvascular disease), I22.0 — Subsequent ST elevation (STEMI) myocardial infarction of anterior wall (myocardium, myocardial, subsequent, anterior), I22.1 — Subsequent ST elevation (STEMI) myocardial infarction of inferior wall (myocardium, myocardial, subsequent, inferior), I22.2 — Subsequent non-ST elevation (NSTEMI) myocardial infarction (myocardium, myocardial, subsequent, subendocardial), I22.8 — Subsequent ST elevation (STEMI) myocardial infarction of other sites (myocardium, myocardial, subsequent, septal), I22.9 — Subsequent ST elevation (STEMI) myocardial infarction of unspecified site (myocardium, myocardial, subsequent), I24.0 — Acute coronary thrombosis not resulting in myocardial infarction (artery, coronary), I63.0 — Cerebral infarction due to thrombosis of precerebral arteries (cerebral, due to, thrombosis, precerebral artery), I63.00 — Cerebral infarction due to thrombosis of unspecified precerebral artery (artery, precerebral, with infarction, due to, thrombosis), I63.01 — Cerebral infarction due to thrombosis of vertebral artery (artery, vertebral, with, infarction, due to, thrombosis), I63.02 — Cerebral infarction due to thrombosis of basilar artery (artery, basilar, with, infarction, due to, thrombosis), I63.03 — Cerebral infarction due to thrombosis of carotid artery (artery, carotid, with, infarction, due to, thrombosis), I63.09 — Cerebral infarction due to thrombosis of other precerebral artery (artery, precerebral, specified NEC, with infarction, due to, thrombosis), I63.1 — Cerebral infarction due to embolism of precerebral arteries (cerebral, due to, embolism, precerebral arteries), I63.10 — Cerebral infarction due to embolism of unspecified precerebral artery (artery, precerebral, with infarction, due to, embolism), I63.11 — Cerebral infarction due to embolism of vertebral artery (artery, vertebral, with, infarction, due to, embolism), I63.12 — Cerebral infarction due to embolism of basilar artery (artery, basilar, with, infarction, due to, embolism), +449 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Contextual Map
Every relationship of I25.2 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 I25.2 with these 4 related codes in Claim Check
Hierarchy
- I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I20-I25 — Ischemic heart diseases[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes2 notes
- I21 — Acute myocardial infarction[Excludes2]: “old myocardial infarction (I25.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I74 — Arterial embolism and thrombosis[Excludes2](via I25.-): “coronary embolism and thrombosis (I21-I25)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I82 — Other venous embolism and thrombosis[Excludes2](via I25.-): “coronary (I21-I25)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- Z86.7 — Personal history of diseases of the circulatory system[Excludes2]: “old myocardial infarction (I25.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- CIR011 — Coronary atherosclerosis and other heart disease[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 302 — ATHEROSCLEROSIS WITH MCC[MS-DRG]: “ATHEROSCLEROSIS WITH MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 303 — ATHEROSCLEROSIS WITHOUT MCC[MS-DRG]: “ATHEROSCLEROSIS WITHOUT MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 17,209 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- History, personal (of), myocardial infarction (old)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Infarct, infarction, myocardium, myocardial (acute) (with stated duration of 4 weeks or less), diagnosed on ECG, but presenting no symptoms[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Infarct, infarction, myocardium, myocardial (acute) (with stated duration of 4 weeks or less), healed or old[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Infarct, infarction, myocardium, myocardial (acute) (with stated duration of 4 weeks or less), past (diagnosed on ECG or other investigation, but currently presenting no symptoms)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Occlusion, occluded, artery, coronary (acute) (thrombotic) (without myocardial infarction), healed or old[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Occlusion, occluded, coronary (artery) (vein) (thrombotic), healed or old[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Oldmyocardial infarction (previous)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Scar, scarring, myocardium, myocardial[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (40)
- I25 — Chronic ischemic heart disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.1 — Atherosclerotic heart disease of native coronary artery[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.10 — Atherosclerotic heart disease of native coronary artery without angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.11 — Atherosclerotic heart disease of native coronary artery with angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.110 — Atherosclerotic heart disease of native coronary artery with unstable angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.111 — Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.112 — Atherosclerotic heart disease of native coronary artery with refractory angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.118 — Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 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 structured 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 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.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
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. "I25.2 — Old myocardial infarction." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/i25.2-old-myocardial-infarction
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionOld myocardial infarction
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), 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 I25.2 in its code family, with their registry titles.
- I25.110 — Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
- I25.111 — Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
- I25.112 — Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
- I25.118 — Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
- I25.119 — Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
- I25.3 — Aneurysm of heart
- I25.4 — Coronary artery aneurysm and dissection
- I25.41 — Coronary artery aneurysm
- I25.42 — Coronary artery dissection
- I25.5 — Ischemic cardiomyopathy