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

ICD-10 I22.9

Billable / Specific HCC v28: 86 MCC

Subsequent ST elevation (STEMI) myocardial infarction of unspecified site

I22
Block
2
Synonyms
525
LCDs
34
Payer Policies
74
Linked CPTs

About ICD-10-CM I22.9

ICD-10-CM code I22.9 represents Subsequent ST elevation (STEMI) myocardial infarction of unspecified site. This is a billable/specific code in the Circulatory System chapter (block I22). The 2026 edition of ICD-10-CM I22.9 became effective on October 1, 2025.

Coding Tips for I22.9

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

HCC capture: document with MEAT each year

I22.9 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

I22.9 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 I22.9. Per CMS ICD-10-CM Tabular 2026.

  • Subsequent acute myocardial infarction of unspecified site
  • Subsequent myocardial infarction (acute) NOS

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 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for I22.9

Local Coverage Determinations (LCDs) from CMS MACs that list I22.9 as a covered diagnosis.

525 LCDs

Showing top 10 of 525 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93313 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93312 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93318 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93317 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8927 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8925 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93314 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8926 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93316 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93315 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I22.9.

34 policies

2 Aetna

Color-Flow Doppler Echocardiography and Myocardial Strain Imaging - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0008
Holter Monitors - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0019

3 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542
Plasma Brain Natriuretic Peptide in the Outpatient Setting - (0028)
Policy ID: MM_0028
Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Automatic External Defibrillators - Policy Article
Policy ID: ART-52458
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation
Policy ID: ART-53775
Billing and Coding: Cardiovascular Nuclear Medicine
Policy ID: ART-56494
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500

CPT Codes Commonly Billed with I22.9

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

74 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

Convert I22.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I22.9 41091 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I22.9, Billing FAQ

Is ICD-10 code I22.9 billable? +

Yes, I22.9 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 I22.9? +

ICD-10 I22.9 includes: Subsequent acute myocardial infarction of unspecified site; Subsequent myocardial infarction (acute) NOS.

Does I22.9 affect Medicare Advantage HCC risk adjustment? +

Yes. I22.9 maps to CMS-HCC v28 category 86. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is I22.9 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 I22.9? +

Procedures frequently paired with I22.9 include: 83880, 92979, C9607, C9600, 92937.

What ICD-9 codes does I22.9 map to? +

Per CMS GEMs, I22.9 maps to ICD-9 codes: 41091. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

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

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included