I23.2
BillableVentricular septal defect as current complication following acute myocardial infarction
HCC Category Mapping
V28HCC 229 — Unstable Angina and Other Acute Ischemic Heart Disease
0.000V24HCC 87 — Unstable Angina and Other Acute Ischemic Heart Disease
0.274ESRDHCC 87 — Unstable Angina and Other Acute Ischemic Heart Disease
0.000RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
A hole in the wall between the lower chambers of the heart that develops as a complication immediately following a heart attack.
Coding Tips
- •This is a serious complication requiring careful documentation; ensure the VSD is documented as a current complication of the acute MI
- •Distinguish between acquired post-MI VSD and any pre-existing septal defects
Clinical Significance
Ventricular septal defect following acute myocardial infarction is a life-threatening mechanical complication where necrotic tissue at the interventricular septum ruptures, creating a communication between the left and right ventricles. This results in significant left-to-right shunting, pulmonary overcirculation, and rapid hemodynamic deterioration. Mortality without surgical repair exceeds 90%, making timely identification and coding critical.
Documentation Requirements
- ✓Documentation of ventricular septal defect as a new complication of acute myocardial infarction
- ✓Echocardiographic confirmation of the ventricular septal defect with evidence of left-to-right shunting
- ✓Temporal relationship establishing the defect occurred during or shortly after the acute myocardial infarction
- ✓Location of the septal rupture (anterior versus posterior) if documented
- ✓The underlying acute myocardial infarction coded separately (I21.x)
- ✓Hemodynamic status and treatment plan
Excludes 1 — Do NOT code together
- acquired ventricular septal defect not specified as current complication following acute myocardial infarction (I51.0)
Commonly Confused Codes
Q21.0 — Ventricular septal defect, congenital: for defects present from birthI23.1 — Atrial septal defect following acute myocardial infarction: hole between atria, not ventriclesI23.3 — Rupture of cardiac wall without hemopericardium: free wall rupture rather than septal ruptureI23.0 — Hemopericardium following acute myocardial infarction: bleeding into pericardial sac
Code Hierarchy
└I23Certain current complications following ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (within the 28 day period)└I23.2Ventricular septal defect as current complication following acute myocardial infarction
└I23.2Ventricular septal defect as current complication following acute myocardial infarction