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ICD-10 Guide
ICD-10 CodesI25.10

I25.10

Billable

Atherosclerotic heart disease of native coronary artery without angina pectoris

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

Code Description

ICD-10 I25.10 is a billable code used to indicate a diagnosis of atherosclerotic heart disease of native coronary artery without angina pectoris.

Key Diagnostic Point:

I25.10 refers to atherosclerotic heart disease of the native coronary artery without angina pectoris. This condition is 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 fatigue, shortness of breath, or atypical chest discomfort, although they do not experience angina pectoris. The anatomy involved includes the coronary arteries that supply blood to the heart, primarily the left and right coronary arteries. Disease progression can lead to ischemic heart disease, heart failure, or myocardial infarction if left untreated. Diagnostic considerations include a thorough patient history, physical examination, and diagnostic tests such as electrocardiograms (ECG), stress tests, and coronary angiography to assess the extent of arterial blockage. Early detection and management are crucial to prevent complications associated with coronary artery disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation to differentiate from other heart conditions.
  • Treatment complexity: Management may involve lifestyle changes, medications, or surgical interventions.
  • Documentation requirements: Detailed clinical documentation is necessary to support diagnosis.
  • Coding specificity: Accurate coding requires understanding of the absence of angina and the specific nature of atherosclerosis.

Audit Risk Factors

  • Common coding errors: Misclassification of the presence of angina.
  • Documentation gaps: Incomplete patient history or lack of diagnostic test results.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

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

I25.10 has significant clinical implications as a leading cause of morbidity and mortality worldwide. Understanding and managing atherosclerotic heart disease is crucial for improving population health outcomes. Quality measures related to this condition often focus on early detection, lifestyle modifications, and effective management strategies. Epidemiologically, the prevalence of coronary artery disease underscores the need for healthcare systems to prioritize cardiovascular health initiatives and preventive care.

ICD-9 vs ICD-10

I25.10 has significant clinical implications as a leading cause of morbidity and mortality worldwide. Understanding and managing atherosclerotic heart disease is crucial for improving population health outcomes. Quality measures related to this condition often focus on early detection, lifestyle modifications, and effective management strategies. Epidemiologically, the prevalence of coronary artery disease underscores the need for healthcare systems to prioritize cardiovascular health initiatives and preventive care.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of atherosclerotic disease without angina. Common denials may arise from insufficient documentation or misclassification of symptoms. It is essential to ensure that all relevant diagnostic tests and clinical evaluations are documented to support the diagnosis and justify the medical necessity of services rendered. Adhering to coding best practices, including the use of modifiers when applicable, can help mitigate billing challenges.

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 I25.10?

I25.10 covers atherosclerotic heart disease of the native coronary artery without the presence of angina pectoris. It includes patients with significant coronary artery stenosis who do not exhibit typical anginal symptoms.

When should I25.10 be used instead of related codes?

I25.10 should be used when a patient has a confirmed diagnosis of atherosclerotic heart disease without angina. If the patient experiences angina, then I25.11 (with angina) would be more appropriate.

What documentation supports I25.10?

Documentation should include a comprehensive patient history, results from diagnostic tests such as ECG or angiography, and a clear statement indicating the absence of angina pectoris.