ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I21

Non-Billable Header

Acute myocardial infarction

I21
Block
0
Synonyms
0
LCDs
1
Payer Policies
10
Linked CPTs

About ICD-10-CM I21

ICD-10-CM code I21 represents Acute myocardial infarction. This is a non-billable header code in the Circulatory System chapter (block I21). The 2026 edition of ICD-10-CM I21 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 2 Excludes

Not included here, the excluded code is not part of I21, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • old myocardial infarction (I25.2)
  • postmyocardial infarction syndrome (I24.1)
  • subsequent type 1 myocardial infarction (I22.-)

Includes

  • cardiac infarction
  • coronary (artery) embolism
  • coronary (artery) occlusion
  • coronary (artery) rupture
  • coronary (artery) thrombosis
  • infarction of heart, myocardium, or ventricle
  • myocardial infarction specified as acute or with a stated duration of 4 weeks (28 days) or less from onset

Use Additional Code

When coding I21, also report these additional codes when applicable.

  • 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)

Medicare LCD Coverage for I21

Local Coverage Determinations (LCDs) from CMS MACs that list I21 as a covered diagnosis.

No Medicare LCDs reference I21 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I21.

1 policies

1 Cigna

Laboratory Testing for Transplantation Rejection - (0465)
Policy ID: MM_0465

CPT Codes Commonly Billed with I21

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

10 linkages
  • 93000 Electrocardiogram for chest pain evaluation Internal Medicine
  • 93015 Stress test for chest pain evaluation Cardiovascular Disease
  • 93563 Echocardiogram for chest pain evaluation Cardiovascular Disease
  • 93565 Transesophageal echocardiogram for chest pain evaluation Cardiovascular Disease
  • 93501 Echocardiogram for chest pain evaluation Cardiovascular Disease
  • 93598 Intravascular ultrasound for chest pain evaluation Cardiovascular Disease
  • 93618 Implantable cardioverter-defibrillator for ventricular tachycardia Cardiovascular Disease
  • 93750 Pacemaker insertion for bradycardia Cardiovascular Disease
  • 93799 Unlisted cardiovascular procedure Cardiovascular Disease
  • 93567 Transesophageal echocardiogram for chest pain evaluation Cardiovascular Disease

ICD-10 I21, Billing FAQ

Is ICD-10 code I21 billable? +

No, I21 is a non-billable header code. Use a more specific child code from block I21 when submitting claims.

What codes are Type 2 Excludes for I21? +

Type 2 Excludes (may be coded together when both conditions exist): old myocardial infarction (I25.2); postmyocardial infarction syndrome (I24.1); subsequent type 1 myocardial infarction (I22.-)

What CPT codes are commonly billed with I21? +

Procedures frequently paired with I21 include: 93000, 93015, 93563, 93565, 93501.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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