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ICD-10 Guide
ICD-10 CodesI25.118

I25.118

Billable

Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris

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

Code Description

ICD-10 I25.118 is a billable code used to indicate a diagnosis of atherosclerotic heart disease of native coronary artery with other forms of angina pectoris.

Key Diagnostic Point:

I25.118 refers to atherosclerotic heart disease of the native coronary artery accompanied by other forms of angina pectoris. This condition is characterized by the buildup of plaque within the coronary arteries, leading to reduced blood flow to the heart muscle. Patients may present with symptoms such as chest pain, shortness of breath, and fatigue, particularly during physical exertion or emotional stress. The anatomy involved includes the coronary arteries, which supply blood to the heart, and the heart muscle itself. Disease progression typically involves the gradual narrowing of the arteries, which can lead to ischemia and potentially result in myocardial infarction if left untreated. Diagnostic considerations include patient history, physical examination, electrocardiograms (ECGs), stress tests, and imaging studies such as angiography. The presence of other forms of angina, such as stable or unstable angina, may complicate the clinical picture and necessitate a thorough evaluation to determine the appropriate management strategy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive assessment of symptoms and risk factors.
  • Treatment complexity: May involve lifestyle modifications, medications, and possibly surgical interventions.
  • Documentation requirements: Detailed clinical documentation is essential to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other forms of heart disease.

Audit Risk Factors

  • Common coding errors: Misclassification of angina types or failure to document the severity.
  • Documentation gaps: Incomplete patient history or lack of supporting diagnostic tests.
  • Billing challenges: Potential for 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

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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

I25.118 has significant clinical implications, as it reflects a prevalent condition that affects a substantial portion of the population, contributing to morbidity and mortality associated with cardiovascular diseases. Understanding this code aids in tracking healthcare utilization patterns and quality measures related to heart disease management. Epidemiologically, the prevalence of atherosclerotic heart disease and its associated angina highlights the need for effective prevention and treatment strategies to improve patient outcomes.

ICD-9 vs ICD-10

I25.118 has significant clinical implications, as it reflects a prevalent condition that affects a substantial portion of the population, contributing to morbidity and mortality associated with cardiovascular diseases. Understanding this code aids in tracking healthcare utilization patterns and quality measures related to heart disease management. Epidemiologically, the prevalence of atherosclerotic heart disease and its associated angina highlights the need for effective prevention and treatment strategies to improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for cardiovascular evaluations and treatments. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services provided. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and regularly reviewing payer guidelines to avoid billing discrepancies.

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 I25.118?

I25.118 encompasses atherosclerotic heart disease of the native coronary artery in the presence of other forms of angina pectoris, including stable angina, unstable angina, and variant angina. It is essential to document the type of angina and its relation to the atherosclerotic disease.

When should I25.118 be used instead of related codes?

I25.118 should be used when there is a confirmed diagnosis of atherosclerotic heart disease with documented episodes of angina. It is crucial to differentiate it from I25.119, which is used when angina is not present.

What documentation supports I25.118?

Documentation should include a detailed patient history, physical examination findings, results from diagnostic tests (such as ECGs and stress tests), and any imaging studies that confirm the presence of atherosclerotic changes and angina symptoms.