Acute Myocardial Infarction and Chronic Total Occlusion

The patient has been diagnosed with an acute myocardial infarction (AMI) and chronic total occlusion of the coronary artery. There is an excludes1 note at code I25.82, Chronic total occlusion of coronary artery, which excludes “acute coronary occlusion with myocardial infarction (I21.-, I22.-).” However, in this case, the occlusion and myocardial infarction are in different arteries. Is it acceptable to assign a code for both the acute MI and the chronic total occlusion? ...

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Note:  The following article synopsis was NOT provided by the AHA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article is a brief coding-focused discussion for ICD-10-CM users about a case involving acute myocardial infarction and chronic total occlusion of a coronary artery. It explains the general issue raised by an excludes note and whether both conditions may be coded when they affect different arteries. The content is relevant to coders, CDI staff, and others reviewing cardiovascular diagnosis coding questions.

Why This Topic Matters

Questions involving myocardial infarction and coronary artery occlusion can affect diagnosis selection and code pairing in cardiovascular records. Understanding the article’s scope helps readers determine whether it addresses an ICD-10-CM excludes note interpretation problem or a broader cardiovascular coding scenario.

What You Will Learn

  • How the article frames the relationship between acute myocardial infarction and chronic total occlusion.
  • How an excludes note is involved in the coding question.
  • What type of cardiovascular diagnosis coding issue the article discusses.
  • How the article addresses a scenario where the two conditions are in different arteries.

Who Should Read This

  • Medical coders
  • Coding educators
  • Clinical documentation improvement specialists
  • Revenue cycle professionals

Codes Discussed

  • ICD-10-CM: I25.82

Code Ranges Discussed

  • ICD-10-CM: I21.-
  • ICD-10-CM: I22.-

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