I21.11
BillableST elevation (STEMI) myocardial infarction involving right coronary artery
HCC Category Mapping
V28HCC 228 — Acute Myocardial Infarction
0.000V24HCC 86 — Acute Myocardial Infarction
0.274ESRDHCC 86 — Acute Myocardial Infarction
0.000RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
A heart attack caused by a blood clot blocking the right coronary artery, with characteristic ST segment elevation visible on an EKG, affecting the inferior wall of the heart.
Coding Tips
- •Right coronary artery STEMI typically causes inferior wall MI; verify documentation confirms RCA involvement
- •Assign the appropriate 7th character for timing of the MI episode
Clinical Significance
STEMI involving the right coronary artery typically affects the inferior wall of the heart and may extend to involve the right ventricle. Right coronary artery occlusion can cause bradycardia, heart block, and hemodynamic compromise. This code is clinically significant because right ventricular involvement can complicate treatment strategies, particularly regarding fluid management and avoidance of nitrates.
Documentation Requirements
- ✓Explicit documentation of STEMI with right coronary artery involvement
- ✓Electrocardiogram findings showing inferior ST elevation (leads II, III, aVF)
- ✓Right-sided electrocardiogram leads if right ventricular involvement is suspected
- ✓Cardiac biomarker elevation
- ✓Cardiac catheterization confirming right coronary artery occlusion
- ✓Documentation of any right ventricular infarction as an associated complication
- ✓Timing of acute event
Commonly Confused Codes
I21.19 — STEMI involving other coronary artery of inferior wall: used when inferior wall STEMI is caused by a vessel other than the right coronary arteryI21.02 — STEMI involving left anterior descending: anterior wall, not inferior wallI21.21 — STEMI involving left circumflex coronary artery: typically causes lateral or posterior wall involvementI22.1 — Subsequent STEMI of inferior wall: for recurrent inferior myocardial infarction within 4 weeks
Code Hierarchy
└I21Acute myocardial infarction└I21.1ST elevation (STEMI) myocardial infarction of inferior wall└I21.11ST elevation (STEMI) myocardial infarction involving right coronary artery
└I21.11ST elevation (STEMI) myocardial infarction involving right coronary artery