What ICD-10 code for Acute STEMI congestive heart failure with hypotension?

The appropriate ICD-10 code for Acute STEMI (ST-Elevation Myocardial Infarction) with congestive heart failure and hypotension is I21.09 for the STEMI, combined with I50.9 for congestive heart failure, unspecified. If hypotension is a significant factor, it may also be relevant to note any underlying causes, but typically, the focus will be on the primary diagnosis codes for the heart conditions. Always consult the latest coding guidelines for specific cases.