A patient experienced a type 1 STEMI 10 days ago. The patient is readmitted and develops a new type 1 NSTEMI during the four-week acute myocardial infarction period. Which ICD-10-CM concept applies?
A.
The new NSTEMI must be coded only as an old myocardial infarction
B.
A subsequent myocardial infarction category may apply because a new type 1 MI occurred within four weeks of the initial qualifying MI
C.
The original STEMI can no longer be reported after discharge
D.
The new NSTEMI is coded as chest pain because another MI cannot occur within four weeks
ICD-10-CM provides category I22 for a subsequent acute myocardial infarction occurring within four weeks—28 days—of an initial acute MI, when the qualifying MI types and circumstances meet the classification requirements.
The FY 2026 Official Guidelines specify that when a patient with a type 1 or unspecified acute MI experiences a new type 1 or unspecified MI within four weeks of the initial MI, a code from category I22 is used together with the appropriate I21 code. Sequencing depends on the circumstances of the encounter.
This rule requires care because type 2 MI and certain other myocardial infarction classifications do not follow the same I22 subsequent-MI logic. CDI specialists therefore need accurate documentation of MI type, anatomic location when applicable, timing, and whether the current event represents a genuinely new infarction rather than ongoing care for the original MI.
The prior STEMI does not become an “old MI” merely because the patient left the hospital; the ICD-10-CM acute MI period extends for four weeks from onset.
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