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ICD-10 Guide
ICD-10 CodesI25.1

I25.1

Non-billable

Atherosclerotic heart disease of native coronary artery

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

Code Description

ICD-10 I25.1 is a used to indicate a diagnosis of atherosclerotic heart disease of native coronary artery.

Key Diagnostic Point:

I25.1 refers to atherosclerotic heart disease of the native coronary artery, a condition characterized by the buildup of atherosclerotic plaques within the coronary arteries, leading to reduced blood flow to the heart muscle. Clinically, patients may present with symptoms such as angina pectoris, shortness of breath, or even myocardial infarction. The anatomy involved primarily includes the left and right coronary arteries, which supply blood to the heart. Disease progression often involves the gradual narrowing of these arteries, which can lead to ischemia and subsequent heart damage. Diagnostic considerations include patient history, physical examination, electrocardiograms (ECGs), stress testing, and imaging studies such as coronary angiography. The presence of risk factors such as hypertension, diabetes, hyperlipidemia, and smoking significantly contributes to the development and progression of this condition, necessitating early detection and management to prevent severe cardiovascular events.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive assessment of cardiovascular risk factors and symptoms.
  • Treatment complexity: Involves lifestyle modifications, pharmacotherapy, and potentially invasive procedures.
  • Documentation requirements: Detailed clinical documentation is necessary to support diagnosis and treatment.
  • Coding specificity: Requires accurate coding to distinguish from other forms of heart disease.

Audit Risk Factors

  • Common coding errors: Misclassification with other heart disease codes.
  • Documentation gaps: Incomplete patient history or lack of risk factor documentation.
  • Billing challenges: Denials due to insufficient evidence of medical necessity.

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

Internal Medicine

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

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Atherosclerotic heart disease significantly impacts population health, being a leading cause of morbidity and mortality worldwide. Effective management of this condition can improve quality measures related to cardiovascular health and reduce healthcare utilization patterns, including hospital admissions for acute coronary events. Epidemiologically, the prevalence of risk factors such as obesity and diabetes is rising, highlighting the need for targeted prevention and intervention strategies.

ICD-9 vs ICD-10

Atherosclerotic heart disease significantly impacts population health, being a leading cause of morbidity and mortality worldwide. Effective management of this condition can improve quality measures related to cardiovascular health and reduce healthcare utilization patterns, including hospital admissions for acute coronary events. Epidemiologically, the prevalence of risk factors such as obesity and diabetes is rising, highlighting the need for targeted prevention and intervention strategies.

Reimbursement & Billing Impact

reimbursement.

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 I25.1?

I25.1 covers atherosclerotic heart disease specifically affecting the native coronary arteries, including stable angina, unstable angina, and myocardial infarction resulting from coronary artery disease.

When should I25.1 be used instead of related codes?

I25.1 should be used when there is clear documentation of atherosclerosis affecting the native coronary arteries, differentiating it from codes for other types of heart disease or unspecified conditions.

What documentation supports I25.1?

Documentation should include a detailed patient history, risk factor assessment, clinical findings, diagnostic test results, and treatment plans that specifically address atherosclerotic changes in the coronary arteries.