I21.A1 Myocardial infarction type 2

✓ Billable ICD-10-CM 2026
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The ICD-10-CM code for Myocardial infarction type 2 is I21.A1 (FY2026). It is a billable, claim-ready diagnosis code.

Classification

Section
I20-I25: Ischemic heart diseases (I20-I25)
Category I21
18 codes (13 billable)
FY2026 Status
Stable since FY2024

Also Known As

ICD-10-CM Alphabetic Index entries that lead to I21.A1:

  • Infarct, infarction › myocardium, myocardial (acute) (with stated duration of 4 weeks or less) › type 2
  • Ischemia, ischemic › demand (coronary) › with myocardial infarction
  • Ischemia, ischemic › demand (coronary) › resulting in myocardial infarction
  • Infarct, infarction › myocardium, myocardial (acute) (with stated duration of 4 weeks or less) › due to › ischemic imbalance
  • Infarct, infarction › myocardium, myocardial (acute) (with stated duration of 4 weeks or less) › subsequent (recurrent) (reinfarction) › type 2
  • Infarct, infarction › myocardium, myocardial (acute) (with stated duration of 4 weeks or less) › secondary to › ischemic imbalance
  • Infarct, infarction › myocardium, myocardial (acute) (with stated duration of 4 weeks or less) › due to › demand ischemia
  • Infarct, infarction › myocardium, myocardial (acute) (with stated duration of 4 weeks or less) › secondary to › demand ischemia
Code First
  • , if applicable, the underlying cause, such as:
  • anemia (D50.0-D64.9)
  • chronic obstructive pulmonary disease (J44.-)
  • paroxysmal tachycardia (I47.0-I47.9)
  • shock (R57.0-R57.9)

Inclusion Terms

  • Myocardial infarction due to demand ischemia
  • Myocardial infarction secondary to ischemic imbalance

U.S. Hospital Utilization

  • An estimated 623,115 U.S. inpatient stays in 2023 included I21.A1 among the documented diagnoses.
  • 6,055 stays listed it as the principal diagnosis.

Source: National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, 2016–2023. National survey-weighted estimates.

Official Coding Guidelines

Do not use I22 for subsequent MI other than type 1/unspecified

Do not assign code I22 for subsequent myocardial infarctions other than type 1 or unspecified. For subsequent type 2 AMI assign only code I21.A1. For subsequent type 4 or type 5 AMI, assign only code I21.A9.

— ICD-10-CM Official Guidelines for Coding and Reporting, FY2026, Section I.C.9.e.4
Type 2 MI: assign I21.A1; code underlying cause first; do not use I24.89

Type 2 myocardial infarction (myocardial infarction due to demand ischemia or secondary to ischemic imbalance) is assigned to code I21.A1, Myocardial infarction type 2 with the underlying cause coded first, if applicable. Do not assign code I24.89, Other forms of acute ischemic heart disease, for the demand ischemia. If a type 2 AMI is described as NSTEMI or STEMI, only assign code I21.A1. Codes I21.01-I21.4 should only be assigned for type 1 AMIs.

— ICD-10-CM Official Guidelines for Coding and Reporting, FY2026, Section I.C.9.e.5

Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026

References

Related Codes

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Reviewed by Prajwal Shrestha, CPC, CRC
Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) · AAPC Member ID 01997614 · About · Editorial policy · Content last reviewed: 2025-10-01

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