I20-I25
Medium Complexity
Ischemic heart diseases
Primary Specialty: Cardiology
Last Updated: 2025-09-10
ICD-10 Codes (107)
85 billable17 category headers
I21I21.0I21.01Billable
I21.02Billable
I21.09Billable
I21.1I21.11Billable
I21.19Billable
I21.2I21.21Billable
I21.29Billable
I21.3Billable
I21.4Billable
I21.9Billable
I22I22.0Billable
I22.1Billable
I22.2Billable
I22.8Billable
I22.9Billable
I23I23.0Billable
I23.1Billable
I23.2Billable
I23.3Billable
I23.4Billable
I23.5Billable
I23.6Billable
I23.7Billable
I23.8Billable
I24I24.0Billable
I24.1Billable
I24.8I24.81Billable
I24.89Billable
I24.9Billable
I25I25.1I25.10Billable
I25.11I25.110Billable
I25.111Billable
I25.112Billable
I25.118Billable
I25.119Billable
I25.2Billable
I25.3Billable
I25.4I25.41Billable
I25.42Billable
I25.5Billable
I25.6Billable
I25.7I25.70I25.700Billable
I25.701Billable
I25.702Billable
I25.708Billable
I25.709Billable
I25.71I25.710Billable
I25.711Billable
I25.712Billable
I25.718Billable
I25.719Billable
I25.72I25.720Billable
I25.721Billable
I25.722Billable
I25.728Billable
I25.729Billable
I25.73I25.730Billable
I25.731Billable
I25.732Billable
I25.738Billable
I25.739Billable
I25.75I25.750Billable
I25.751Billable
I25.752Billable
I25.758Billable
I25.759Billable
I25.76I25.760Billable
I25.761Billable
I25.762Billable
I25.768Billable
I25.769Billable
I25.79I25.790Billable
I25.791Billable
I25.792Billable
I25.798Billable
I25.799Billable
I25.8I25.81I25.810Billable
I25.811Billable
I25.812Billable
I25.82Billable
I25.83Billable
I25.84Billable
I25.85Billable
I25.89Billable
I25.9Billable
Updates & Changes
FY 2026 Updates
Current Year
New Codes (2)
I21.A9
Myocardial infarction type 4a (related to PCI), unspecified vessel
I21.B
Myocardial infarction type 4b (related to stent thrombosis)
Revised Codes (1)
I25.110
Atherosclerotic heart disease of native coronary artery with unstable angina pectoris - updated troponin criteria
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Added fourth universal definition of myocardial infarction types
- •FY 2024: Enhanced coronary artery disease complexity coding
- •FY 2023: Updated STEMI/NSTEMI classification criteria
Upcoming Changes
- •Proposed cardiac CT angiography-specific codes
- •Under consideration: Enhanced heart team decision coding
Implementation Guidance
- •Review all FY 2026 updates for I20-I25 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
high priority
The I20-I25 range in the ICD-10 pertains to ischemic heart diseases, a group of conditions characterized by reduced blood supply to the heart. This range includes angina pectoris, acute and chronic forms of ischemic heart disease, and certain current complications following acute myocardial infarction. These codes are vital for accurately documenting patient diagnoses, tracking epidemiological trends, and ensuring appropriate reimbursement for services.
Key Usage Points:
- •Always code to the highest level of specificity within the I20-I25 range.
- •Use additional codes, when applicable, to identify exposure to environmental tobacco smoke, history of tobacco use, or tobacco dependence.
- •For patients with both atherosclerosis and angina pectoris, the atherosclerosis should be sequenced first.
- •When coding for acute myocardial infarctions, the time period must be specified (e.g., initial episode of care, subsequent episode of care).
- •For patients with stable angina and unstable angina, code both conditions separately.
Coding Guidelines
When to Use:
- ✓When a patient presents with chest pain due to reduced blood flow to the heart.
- ✓When a patient is diagnosed with chronic ischemic heart disease.
- ✓When a patient is admitted for an acute myocardial infarction.
- ✓When a patient has a history of ischemic heart disease and presents for a follow-up visit.
- ✓When a patient presents with complications following a recent myocardial infarction.
When NOT to Use:
- ✗When a patient presents with chest pain not confirmed as angina pectoris.
- ✗When a patient has a history of myocardial infarction but no current symptoms or conditions related to ischemic heart disease.
- ✗When a patient presents with heart failure without a specified link to ischemic heart disease.
- ✗When a patient has a congenital heart disease.
Code Exclusions
Always verify exclusions by cross-referencing the patient's clinical documentation and the ICD-10's official guidelines.
Documentation Requirements
Proper documentation for ischemic heart diseases should include the type of disease, its acuity, and any related complications. Information on the patient's history of tobacco use or exposure is also important. Documentation should be clear, concise, and based on clinical findings.
Clinical Information:
- •Type of ischemic heart disease (e.g., angina pectoris, acute myocardial infarction)
- •Acuity of the condition (e.g., chronic, acute)
- •Any complications related to the disease
- •Tobacco use or exposure
- •Treatment plan
Supporting Evidence:
- •Clinical notes
- •Lab results
- •Imaging reports
- •Patient history
Good Documentation Example:
Patient presents with chest pain. EKG shows ST elevation. Diagnosed with acute myocardial infarction. History of tobacco use. Admitted for treatment.
Poor Documentation Example:
Patient has chest pain. EKG abnormal. Admitted.
Common Documentation Errors:
- ⚠Not specifying the type of ischemic heart disease
- ⚠Failing to document the acuity of the condition
- ⚠Not including information on tobacco use or exposure
- ⚠Not documenting related complications
Range Statistics
6
Total Codes
85
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:9
Coding Complexity
Medium
Complexity Rating
The I20-I25 range has a medium complexity rating due to the need for specificity in coding. Coders must accurately identify the type of ischemic heart disease, its acuity, and any related complications. Additional codes may also be required to document tobacco use or exposure. However, with careful attention to clinical documentation, these codes can be applied accurately and effectively.
Key Factors:
- ▸The need to specify the type of ischemic heart disease
- ▸The need to indicate the acuity of the condition
- ▸The requirement for additional codes for tobacco use or exposure
- ▸The possibility of complications related to the disease
Specialty Focus
The I20-I25 range is primarily used by cardiologists, but can also be relevant for internists, family practitioners, and emergency medicine specialists. It covers a broad spectrum of ischemic heart diseases and related conditions.
Primary Specialties:
Cardiology
70%
Internal Medicine
20%
Emergency Medicine
10%
Clinical Scenarios:
- • A patient presents to the ER with severe chest pain and is diagnosed with an acute myocardial infarction.
- • A patient with a history of angina pectoris comes in for a routine follow-up visit.
- • A patient presents with chest pain and shortness of breath. They are diagnosed with chronic ischemic heart disease and heart failure.
- • A patient is admitted for complications following a recent myocardial infarction.
- • A patient with a history of tobacco use presents with chest pain. They are diagnosed with angina pectoris.
Resources & References
A variety of resources are available to assist with coding ischemic heart diseases. These include the ICD-10's official guidelines, clinical reference materials, and educational resources.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Health Information Management Association (AHIMA) Coding Guidelines
- Centers for Medicare & Medicaid Services (CMS) Coding Guidelines
Clinical References:
- American Heart Association (AHA) Clinical Guidelines
- American College of Cardiology (ACC) Clinical Guidelines
Educational Materials:
- AHIMA ICD-10 Training Materials
- CMS ICD-10 Provider Resources
Frequently Asked Questions
Can I use a code from the I20-I25 range for a patient with a history of myocardial infarction but no current symptoms or conditions?
No, these codes should only be used for current conditions. For a history of myocardial infarction, use a code from the Z86.7- range.
How do I code for a patient with both atherosclerosis and angina pectoris?
In this case, the atherosclerosis should be sequenced first, followed by the code for angina pectoris.