I25.2
BillableOld myocardial infarction
HCC Category Mapping
RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
Permanent damage to the heart muscle from a previous heart attack that occurred in the past.
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 weeksI22.0-I22.9 — Subsequent myocardial infarction: for recurrent events within 4 weeks of the initialI25.10 — Atherosclerotic heart disease without angina: coronary artery disease without reference to prior myocardial infarctionI25.5 — Ischemic cardiomyopathy: if prior myocardial infarction has caused ventricular dysfunctionZ86.73 — Personal history of transient ischemic attack: different condition entirely