I25.2 ICD-10-CM Code: Old myocardial infarction
I25.2 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Ischemic heart diseases (I20-I25)
I25.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOld myocardial infarction
Permanent damage to the heart muscle from a previous heart attack that occurred in the past.
Buddy Insight
Old myocardial infarction (also known as healed or prior myocardial infarction) indicates permanent myocardial damage from a previous heart attack.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 188
RAF 0.052
Code Book Path
Inclusion Terms
Official- Healed myocardial infarction
- Past myocardial infarction diagnosed by ECG or other investigation, but currently presenting no symptoms
Excludes 2
Official- non-ischemic myocardial injury (I5A)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I25.2 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for I25.2 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I25.2 in this effective period.
Use Additional
Official- code to identify:
- chronic total occlusion of coronary artery (I25.82)
- exposure to environmental tobacco smoke (Z77.22)
- history of tobacco dependence (Z87.891)
- occupational exposure to environmental tobacco smoke (Z57.31)
Code Also
OfficialICD-10-CM does not list Code Also instructions for I25.2 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is I25.2 an HCC code?
I25.2 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Coronary Artery Disease and Angina under the Part D RxHCC model.
- Code
- I25.2
- Description
- Old myocardial infarction
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work I25.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I25.2
For I25.2 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I25.2 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I25.2 is the ICD-10-CM diagnosis code for old myocardial infarction. Permanent damage to the heart muscle from a previous heart attack that occurred in the past. I25.2 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering ischemic heart diseases (i20-i25).
I25.2 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing I25.2 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I25.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is used for healed or remote myocardial infarctions, not acute events
- •Documentation should indicate the MI occurred weeks, months, or years prior; specify the location if known (anterior, inferior, etc.)
Clinical Significance
Old myocardial infarction (also known as healed or prior myocardial infarction) indicates permanent myocardial damage from a previous heart attack. This code is used after the 4-week acute window has passed. Importantly, this code does NOT map to any HCC in either V24 or V28 models, meaning it provides no risk adjustment value despite indicating significant cardiovascular history.
Documentation Requirements
- ✓Documentation of a previous myocardial infarction that has healed
- ✓Timing confirmation that the myocardial infarction occurred more than 4 weeks ago
- ✓Evidence of prior myocardial infarction (electrocardiogram findings such as Q waves, imaging showing wall motion abnormalities or scar)
- ✓Current clinical relevance justifying code assignment (affects management, prognosis, or treatment decisions)
Commonly Confused Codes
- •I21.01-I21.4: Acute myocardial infarction codes: for events within the first 4 weeks
- •I22.0-I22.9: Subsequent myocardial infarction: for recurrent events within 4 weeks of the initial
- •I25.10: Atherosclerotic heart disease without angina: coronary artery disease without reference to prior myocardial infarction
- •I25.5: Ischemic cardiomyopathy: if prior myocardial infarction has caused ventricular dysfunction
- •Z86.73: Personal history of transient ischemic attack: different condition entirely