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ICD-10 Guide
ICD-10 CodesI25.768

I25.768

Billable

Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I25.768 is a billable code used to indicate a diagnosis of atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris.

Key Diagnostic Point:

I25.768 refers to atherosclerosis of a bypass graft of the coronary artery in a transplanted heart, accompanied by other forms of angina pectoris. This condition arises when there is a buildup of plaque in the grafted coronary arteries, leading to reduced blood flow to the heart muscle. Clinically, patients may present with chest pain or discomfort, which can vary in intensity and duration, often exacerbated by physical exertion or emotional stress. The anatomy involved includes the coronary arteries that have been surgically bypassed during heart transplantation. Disease progression can lead to ischemic heart disease, heart failure, or even myocardial infarction if not managed appropriately. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as angiography or stress testing to evaluate graft patency and assess the severity of angina. Regular follow-up and monitoring are crucial for managing this condition effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of post-transplant complications and graft health.
  • Treatment complexity: Involves multi-disciplinary management including cardiology and transplant specialists.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other forms of coronary artery disease.

Audit Risk Factors

  • Common coding errors: Misidentifying the type of angina or failing to document the graft status.
  • Documentation gaps: Incomplete records regarding the patient's history of coronary artery disease or transplant details.
  • Billing challenges: Potential denials if the relationship between symptoms and the graft condition is not clearly established.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Transplant Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

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CPT Code

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Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I25.768 lies in its association with increased morbidity and mortality in heart transplant patients. Atherosclerosis in grafts can lead to significant complications, affecting population health by increasing hospitalizations and healthcare costs. Quality measures focus on monitoring graft health and managing angina symptoms effectively. Understanding the epidemiology of this condition is crucial for healthcare providers to implement preventive strategies and improve patient outcomes.

ICD-9 vs ICD-10

The clinical significance of I25.768 lies in its association with increased morbidity and mortality in heart transplant patients. Atherosclerosis in grafts can lead to significant complications, affecting population health by increasing hospitalizations and healthcare costs. Quality measures focus on monitoring graft health and managing angina symptoms effectively. Understanding the epidemiology of this condition is crucial for healthcare providers to implement preventive strategies and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical evidence and that all relevant procedures are coded accurately. Common denials may arise from insufficient documentation linking the symptoms to the graft condition or from coding errors. Best practices include regular audits of coding accuracy and ensuring that all clinical notes reflect the patient's current status and treatment plan.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I25.768?

I25.768 covers atherosclerosis specifically affecting the bypass grafts of coronary arteries in patients with a transplanted heart, along with the presence of other forms of angina pectoris, which may include stable angina or unstable angina.

When should I25.768 be used instead of related codes?

I25.768 should be used when there is documented atherosclerosis of the bypass graft in a transplanted heart accompanied by angina symptoms. It is important to differentiate it from codes that do not specify angina or those that pertain to native coronary arteries.

What documentation supports I25.768?

Documentation should include a detailed history of the patient's heart transplant, any previous cardiovascular interventions, current symptoms of angina, results from diagnostic tests such as angiography, and treatment plans that address the graft condition.