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ICD-10 Guide
DiagnosesAtherosclerosis Coronary Artery Disease

Atherosclerosis Coronary Artery Disease

ICD-10 Coding for Atherosclerosis Coronary Artery Disease(I25.10, I25.11-)

PRIMARY SPECIALTYCardiology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Atherosclerosis Coronary Artery Disease?
Essential facts and insights about Atherosclerosis Coronary Artery Disease

Key Clinical Considerations:

  • Patients may present with chest pain (angina), shortness of breath, or fatigue during exertion.
  • Laboratory findings may include elevated cholesterol levels, particularly low-density lipoprotein (LDL) and triglycerides.
  • Physical examination may reveal signs of heart failure, such as edema, or abnormal heart sounds.
  • Imaging findings may include coronary angiography showing narrowed coronary arteries or non-invasive imaging revealing ischemia.
  • Severity can be staged based on the extent of coronary artery involvement and functional capacity (e.g., New York Heart Association functional classification).

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the patient's symptoms, risk factors, and any diagnostic tests performed.
  • Specific terminology such as 'atherosclerosis', 'coronary artery disease', and 'ischemic heart disease' must be used.
  • Examples include documenting the patient's angina type (stable vs unstable) and any prior myocardial infarctions.
  • Medical necessity must be established through documentation of symptoms and the need for diagnostic testing or treatment.
  • Quality measures may require documentation of risk factor management, such as lipid levels and blood pressure control.

Coding Guidelines

Usage Guidelines & Examples

  • Use I25.10 for unspecified atherosclerotic heart disease and I25.11 for atherosclerotic heart disease with angina.
  • Do not use this code for non-atherosclerotic heart diseases such as hypertensive heart disease or valvular heart disease.
  • Related codes include I25.2 (old myocardial infarction) and I25.3 (atherosclerosis of coronary artery bypass grafts).
  • Common errors include using the code for acute coronary syndromes without proper documentation of chronic disease.
  • In complex cases, ensure to document all contributing factors and consider additional codes for comorbidities.

Code Exclusions

Important Exclusions

  • Excludes acute coronary syndromes (I21) and other non-atherosclerotic heart diseases.
  • Alternative codes for excluded conditions include I21 for acute myocardial infarction.
  • Conditions are excluded due to different underlying pathophysiology and treatment approaches.
  • Common mistakes include misclassifying acute events as chronic atherosclerosis.
  • Related but distinct conditions include coronary artery spasm and non-ischemic cardiomyopathy.

Related ICD-10 Codes

Primary Codes
I25.10
Atherosclerotic heart disease, unspecified
I25.11
Atherosclerotic heart disease with angina pectoris
Differential Codes
I25.11-
I20.1

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Applies to patients with chronic coronary artery disease and related ischemic heart conditions.
  • Patient populations include adults, particularly those over 45 years, with risk factors such as smoking, obesity, and family history.
  • Clinical settings include outpatient cardiology clinics, inpatient hospital settings, and emergency departments.
  • Specialty-specific applications are relevant in cardiology, internal medicine, and primary care.
  • Treatment contexts include management of stable angina, post-myocardial infarction care, and pre-operative assessments.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with atherosclerosis coronary artery disease based on clinical findings of chest pain and stress test results.'

Template 2

Template: 'Clinical presentation consistent with atherosclerosis coronary artery disease including exertional angina and risk factors such as hypertension.'

Template 3

Template: 'Diagnostic criteria for atherosclerosis coronary artery disease met as evidenced by coronary angiography showing significant stenosis.'

Template 4

Template: 'Treatment plan initiated for atherosclerosis coronary artery disease with lifestyle modifications and medication management.'

Template 5

Template: 'Follow-up care for atherosclerosis coronary artery disease including monitoring of lipid levels and blood pressure.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include clinical symptoms, diagnostic test results, and treatment plans.

How does this differ from similar diagnoses?

Atherosclerosis coronary artery disease is chronic, while acute coronary syndromes are time-sensitive events.

What are common billing considerations?

Ensure documentation supports medical necessity and aligns with coding guidelines for reimbursement.

What procedures are typically associated?

CPT codes for associated procedures may include cardiac catheterization and stress testing.

Are there any quality reporting implications?

Quality measures may include monitoring lipid levels and adherence to treatment guidelines.