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ICD-10 Guide
ICD-10 CodesI25.711

I25.711

Billable

Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm

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

Code Description

ICD-10 I25.711 is a billable code used to indicate a diagnosis of atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm.

Key Diagnostic Point:

I25.711 refers to atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm. This condition arises when there is a buildup of plaque in the grafted veins used for coronary artery bypass surgery, leading to reduced blood flow to the heart muscle. Patients typically present with symptoms of angina pectoris, which is characterized by chest pain or discomfort due to inadequate blood supply to the heart. The spasm of coronary arteries can further exacerbate the angina, causing intermittent episodes of chest pain. The anatomy involved includes the coronary arteries and the grafts, which are often harvested from the patient's own veins, such as the saphenous vein. Disease progression can lead to significant complications, including myocardial infarction if not managed appropriately. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as angiography to assess the patency of the grafts and the presence of spasm. Stress tests may also be utilized to evaluate the functional capacity of the heart and the severity of angina symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassifying the type of angina or failing to document the spasm.
  • Documentation gaps may arise if the clinical notes do not clearly indicate the presence of angina or the specifics of the grafts.
  • Billing challenges can occur if the documentation does not support the severity of the condition or if the spasm is not adequately documented.

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

Cardiothoracic 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

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I25.711 lies in its association with increased morbidity and potential mortality due to compromised blood flow to the heart. Population health impact includes a higher prevalence of coronary artery disease in patients with a history of bypass surgery, necessitating ongoing monitoring and management. Quality measures may focus on the timely identification and treatment of angina and spasm, which can improve patient outcomes. Understanding healthcare utilization patterns related to this condition is crucial for effective resource allocation and patient care strategies.

ICD-9 vs ICD-10

The clinical significance of I25.711 lies in its association with increased morbidity and potential mortality due to compromised blood flow to the heart. Population health impact includes a higher prevalence of coronary artery disease in patients with a history of bypass surgery, necessitating ongoing monitoring and management. Quality measures may focus on the timely identification and treatment of angina and spasm, which can improve patient outcomes. Understanding healthcare utilization patterns related to this condition is crucial for effective resource allocation and patient care strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for the procedures performed is clearly documented. Common denials may arise from insufficient documentation or failure to demonstrate the severity of the condition. Coding best practices recommend using specific codes that reflect the patient's condition accurately, as well as maintaining thorough clinical notes that support the diagnosis and treatment provided.

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 I25.711?

I25.711 covers atherosclerosis affecting autologous vein grafts used in coronary artery bypass surgery, specifically when accompanied by angina pectoris and documented coronary artery spasm. It is essential to confirm the presence of these conditions through clinical evaluation and diagnostic testing.

When should I25.711 be used instead of related codes?

I25.711 should be used when the patient has a documented history of angina pectoris and coronary artery spasm in conjunction with atherosclerosis of the bypass grafts. If angina is not present or spasm is not documented, other codes such as I25.710 may be more appropriate.

What documentation supports I25.711?

Documentation for I25.711 should include a detailed clinical history indicating the presence of angina pectoris, results from diagnostic tests confirming coronary artery spasm, and notes on the status of the autologous vein grafts. Clear and thorough documentation is crucial for accurate coding and reimbursement.