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I5A ICD-10-CM Code: Non-ischemic myocardial injury (non-traumatic)

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Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
3 inclusion terms · 2 Excludes1 · 1 Excludes2 · 13 code-first instructions

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

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.

Code firstSequence the underlying condition before this code
  • the underlying cause, if known and applicable, such as:
  • acute kidney failure (N17.-)
  • acute myocarditis (I40.-)
  • cardiomyopathy (I42.-)

+9 more in Instructions

Excludes1Never report with this code
  • acute myocardial infarction (I21.-)
  • injury of heart (S26.-)
Excludes2Not included here; may be reported together
  • other acute ischemic heart diseases (I24.-)
IncludesWhat this code covers
  • Acute (non-ischemic) myocardial injury
  • Chronic (non-ischemic) myocardial injury
  • Unspecified (non-ischemic) myocardial injury

Where it sits Source: CMS/NCHS

Under:Chapter 9: Diseases of the Circulatory SystemI30-I5A Other forms of heart disease

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

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 v44, Appendix B.

  • MS-DRG 314 — OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC (MDC 05)
  • MS-DRG 315 — OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC (MDC 05)
  • MS-DRG 316 — OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/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 I5A 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

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Acute (non-ischemic) myocardial injury
  • Chronic (non-ischemic) myocardial injury
  • Unspecified (non-ischemic) myocardial injury

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).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • the underlying cause, if known and applicable, such as:
  • acute kidney failure (N17.-)
  • acute myocarditis (I40.-)
  • cardiomyopathy (I42.-)
  • chronic kidney disease (CKD) (N18.-)
  • heart failure (I50.-)
  • hypertensive urgency (I16.0)
  • nonrheumatic aortic valve disorders (I35.-)
  • paroxysmal tachycardia (I47.-)
  • pulmonary embolism (I26.-)
  • pulmonary hypertension (I27.0, I27.2-)
  • sepsis (A41.-)
  • takotsubo syndrome (I51.81)

Coder workflow for I5A

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

Before you code I5A

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I5A. 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 a condition named in I5A’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, S26

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then I5A.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewN17, I40, I42, N18, I50, I16.0

Consider I5A. Then 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 underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes1 — check before selecting I5A(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I5A: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareI21, S26

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

  • Excludes2 — not part of I5A(1 note)

    Coding workflow: The conditions named in this note are not included in I5A. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareI24

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

  • Code First — sequencing check(13 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before I5A. Do not add an underlying condition the record does not document.

    ReviewN17, I40, I42, N18, I50, I16.0

    See the official tabular notes · 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.

Don’t confuse I5A with…

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

The codes most likely to be picked instead of I5A — 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.

  • I21.9— Specificity relationship (Review)

    Both describe damaged myocardium, and a raised troponin is common to each — but I21.9 asserts an infarction, meaning ischemia caused the damage, while I5A asserts myocardial injury that is explicitly non-ischemic and non-traumatic. Because acute myocardial infarction is an Excludes1 on I5A, exactly one of them describes a given event.

    Deciding question: Does the provider attribute the myocardial damage to ischemia?

    Full comparison: I5A vs I21.9 →

  • I21— 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 acute myocardial infarction moves the case to I21; the two are not reported together unless documented as unrelated.

    Full comparison: I5A vs I21 →

  • S26— 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 injury of heart moves the case to S26; the two are not reported together unless documented as unrelated.

    Full comparison: I5A vs S26 →

  • I24— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of other acute ischemic heart diseases adds I24; it is not part of this code and both may be reported when both are documented.

    Full comparison: I5A vs I24 →

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

Non-ischemic myocardial injury (non-traumatic) is a billable ICD-10-CM diagnosis code (I5A).

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

Coding Notes

MedCoder editorial — not official ICD-10-CM text; reviewed against the cited source

What this code means

I5A reports non-ischemic, non-traumatic myocardial injury — the classification’s home for myocardial injury (typically a troponin elevation) that is not caused by ischemia and not caused by trauma. Its inclusion terms cover the acute, chronic, and unspecified forms, so the code does not split by acuity.

Coding guidance

  • It is not an infarction code. Acute myocardial infarction (I21.-) is an Excludes1, as is injury of heart (S26.-) for traumatic causes — I5A exists precisely for the elevated-troponin picture that is neither.
  • Sequence the underlying cause first when it is known and applicable. The Code First list names acute kidney failure (N17.-), acute myocarditis (I40.-), cardiomyopathy (I42.-), chronic kidney disease (N18.-), heart failure (I50.-), hypertensive urgency (I16.0), nonrheumatic aortic valve disorders (I35.-), paroxysmal tachycardia (I47.-), pulmonary embolism (I26.-), pulmonary hypertension (I27.0, I27.2-), sepsis (A41.-), and takotsubo syndrome (I51.81).
  • Other acute ischemic heart disease (I24.-) is Excludes2, not Excludes1 — that condition is not part of I5A, but the two may be reported together when both are documented.

Decision-rule scenarios

Documentation: A patient with documented sepsis has an elevated troponin the provider attributes to the sepsis rather than to ischemia.

Coding question: What does the classification ask for?

Rule: Sepsis appears on I5A’s Code First list, so the underlying cause is sequenced ahead of the myocardial-injury code. The deciding element is the provider attributing the injury to a non-ischemic cause; an ischemic attribution points to the infarction or ischemic-heart-disease codes instead.

Documentation: The record documents an acute myocardial infarction.

Coding question: Is I5A reported alongside it?

Rule: No — acute myocardial infarction (I21.-) is an Excludes1 on I5A, so the two are not reported together for the same event. The deciding element is whether the documented mechanism is ischemic.

Scenarios state the decision rule, not a code assignment — code selection always follows the provider's documentation and the ICD-10-CM Official Guidelines.

Documentation checklist

  • That the myocardial injury is non-ischemic and non-traumatic — the two Excludes1 boundaries.
  • The underlying cause, when known, since the Code First note sequences it first.
  • Acute, chronic, or unspecified, which the inclusion terms all cover without changing the code.

Codes are assigned from provider documentation; a coder never infers a diagnosis.

Common mistakes

  • Reporting I5A together with an acute MI code for the same event.
  • Using it for traumatic cardiac injury, which belongs to S26.-.
  • Omitting the underlying cause when the record names one on the Code First list.

Clinical context (coding perspective)

A raised troponin is a marker of myocardial injury, not of infarction by itself — infarction adds ischemia to the picture. I5A gives that distinction a code, which is why the documentation question is always what the provider says caused the elevation.

Written and reviewed by MedCoder against the official ICD-10-CM files; educational, not medical or billing advice. The official tabular notes and guidelines above take precedence in every case.

Decision Points

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

  1. Sequencing: 13 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 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

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

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 I5A 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 2 Excludes2 notes: I24 — Other acute ischemic heart diseases, I25 — Chronic ischemic heart disease.

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 66 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 314 (MDC 05), DRG 315 (MDC 05), DRG 316 (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):CIR015 — Other and ill-defined 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 process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

I25.798 — Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris, I25.799 — Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris, I25.811 — Atherosclerosis of native coronary artery of transplanted heart without angina pectoris, I25.812 — Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris, I25.85 — Chronic coronary microvascular dysfunction, I25.89 — Other forms of chronic ischemic heart disease, I25.9 — Chronic ischemic heart disease, unspecified, I42.00 — Dilated cardiomyopathy, unspecified, I42.01 — Familial-genetic dilated cardiomyopathy, I42.09 — Other dilated cardiomyopathy, I42.1 — Obstructive hypertrophic cardiomyopathy, I42.2 — Other hypertrophic cardiomyopathy, I42.3 — Endomyocardial (eosinophilic) disease, I42.4 — Endocardial fibroelastosis, I42.5 — Other restrictive cardiomyopathy, I42.6 — Alcoholic cardiomyopathy, I42.7 — Cardiomyopathy due to drug and external agent, I42.81 — Arrhythmogenic cardiomyopathy, I42.89 — Other cardiomyopathies not elsewhere classified, I42.9 — Cardiomyopathy, unspecified, +45 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other and ill-defined heart disease).

I51.0 — Cardiac septal defect, acquired, I51.1 — Rupture of chordae tendineae, not elsewhere classified, I51.2 — Rupture of papillary muscle, not elsewhere classified, I51.3 — Intracardiac thrombosis, not elsewhere classified, I51.5 — Myocardial degeneration, I51.7 — Cardiomegaly, I51.81 — Takotsubo syndrome, I51.89 — Other ill-defined heart diseases, I51.9 — Heart disease, unspecified, I52 — Other heart disorders in diseases classified elsewhere, M05.30 — Rheumatoid heart disease with rheumatoid arthritis of unspecified site, M05.311 — Rheumatoid heart disease with rheumatoid arthritis of right shoulder, M05.312 — Rheumatoid heart disease with rheumatoid arthritis of left shoulder, M05.319 — Rheumatoid heart disease with rheumatoid arthritis of unspecified shoulder, M05.321 — Rheumatoid heart disease with rheumatoid arthritis of right elbow, M05.322 — Rheumatoid heart disease with rheumatoid arthritis of left elbow, M05.329 — Rheumatoid heart disease with rheumatoid arthritis of unspecified elbow, M05.331 — Rheumatoid heart disease with rheumatoid arthritis of right wrist, M05.332 — Rheumatoid heart disease with rheumatoid arthritis of left wrist, M05.339 — Rheumatoid heart disease with rheumatoid arthritis of unspecified wrist, +15 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.

Blood Glucose Test, Lipid Panel, Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of I5A 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 I5A with these 12 related codes in Claim Check

Hierarchy

Excludes1

Excludes2

Code First (13)

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

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. 15,708 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Injury, heart (traumatic), non-traumatic (acute) (chronic) (non-ischemic)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Injury, myocardial (acute) (chronic) (non-ischemic) (non-traumatic)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Neurogenic stunned myocardium[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Stunned myocardium, neurogenic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Change history

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.

Indexed Clinical Terms (4)

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.

Common coding questions

MedCoder editorial

When is I5A used instead of an acute MI code?

When the documented myocardial injury is non-ischemic — typically a troponin elevation the provider attributes to something other than ischemia. Acute myocardial infarction (I21.-) is an Excludes1 on I5A, so the two are not reported together for the same event.

Does I5A need another code with it?

Yes when the cause is known: its Code First note sequences the underlying cause ahead of it — acute kidney failure, myocarditis, cardiomyopathy, chronic kidney disease, heart failure, hypertensive urgency, pulmonary embolism, sepsis and takotsubo syndrome are among those listed.

Is there an acute and a chronic version of I5A?

No — acute, chronic, and unspecified non-ischemic myocardial injury are all inclusion terms on I5A itself, so the documented acuity does not change the code.

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
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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, coding notes, decision checklist 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. "I5A — Non-ischemic myocardial injury (non-traumatic)." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i5a-non-ischemic-myocardial-injury-non-traumatic

Change history

  • FY2022 — October 1, 2021
    Added to the code set
    Non-ischemic myocardial injury (non-traumatic)
    FY2022 changes