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

ICD-10 I21.A9

Billable / Specific HCC v28: 86 MCC

Other myocardial infarction type

I21
Block
6
Synonyms
602
LCDs
30
Payer Policies
51
Linked CPTs

About ICD-10-CM I21.A9

ICD-10-CM code I21.A9 represents Other myocardial infarction type. This is a billable/specific code in the Circulatory System chapter (block I21). The 2026 edition of ICD-10-CM I21.A9 became effective on October 1, 2025.

Coding Tips for I21.A9

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I21.A9 is a CMS-HCC v28 risk-adjustment code (category 86). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: MCC

I21.A9 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I21.A9. Per CMS ICD-10-CM Tabular 2026.

  • Myocardial infarction associated with revascularization procedure
  • Myocardial infarction type 3
  • Myocardial infarction type 4a
  • Myocardial infarction type 4b
  • Myocardial infarction type 4c
  • Myocardial infarction type 5

Coding Notes

Code Also

  • complication, if known and applicable, such as:
  • (acute) stent occlusion (T82.897-)
  • (acute) stent stenosis (T82.855-)
  • (acute) stent thrombosis (T82.867-)
  • cardiac arrest due to underlying cardiac condition (I46.2)
  • complication of percutaneous coronary intervention (PCI) (I97.89)
  • occlusion of coronary artery bypass graft (T82.218-)

Code First

  • , if applicable, postprocedural myocardial infarction following cardiac surgery (I97.190), or postprocedural myocardial infarction during cardiac surgery (I97.790)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 86
ESRD-HCC
Category 86
RxHCC (Part D)
Category 86

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, MCC

codes Other myocardial infarction type. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for I21.A9

Local Coverage Determinations (LCDs) from CMS MACs that list I21.A9 as a covered diagnosis.

602 LCDs

Showing top 10 of 602 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93270 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93298 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93225 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93271 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93246 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93272 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93242 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93228 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 0938T →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 0937T →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I21.A9.

30 policies

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476
Billing and Coding: B-type Natriuretic Peptide (BNP) Testing
Policy ID: ART-56605
Billing and Coding: Echocardiography
Policy ID: ART-56625

CPT Codes Commonly Billed with I21.A9

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

51 linkages
  • 83880 CMS LCD: Billing and Coding: B-type Natriuretic Peptide (BNP) Testing CMS LCD
  • 92979 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9607 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9600 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92937 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92920 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9608 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92943 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9601 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92941 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD

ICD-10 I21.A9, Billing FAQ

Is ICD-10 code I21.A9 billable? +

Yes, I21.A9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I21.A9? +

ICD-10 I21.A9 includes: Myocardial infarction associated with revascularization procedure; Myocardial infarction type 3; Myocardial infarction type 4a, and 3 more clinical synonyms.

Does I21.A9 affect Medicare Advantage HCC risk adjustment? +

Yes. I21.A9 maps to CMS-HCC v28 category 86. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is I21.A9 a CC or MCC for inpatient DRG? +

Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with I21.A9? +

Procedures frequently paired with I21.A9 include: 83880, 92979, C9607, C9600, 92937.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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