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ICD-10 Guide
ICD-10 CodesI25.728

I25.728

Billable

Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris

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

Code Description

ICD-10 I25.728 is a billable code used to indicate a diagnosis of atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris.

Key Diagnostic Point:

I25.728 refers to atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris. This condition arises when there is a buildup of plaque in the grafted arteries that were previously used to bypass blocked coronary arteries. Clinically, patients may present with symptoms of angina pectoris, which can manifest as chest pain or discomfort, often triggered by physical activity or emotional stress. The anatomy involved includes the coronary arteries and the grafts, which may be sourced from the patient's own arteries or veins. Disease progression can lead to reduced blood flow to the heart muscle, increasing the risk of myocardial infarction. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as angiography or stress testing to evaluate the patency of the grafts and the presence of ischemia. Management may involve lifestyle modifications, pharmacotherapy, and possibly revascularization procedures if symptoms persist or worsen.

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 misidentifying the type of angina or failing to document the history of bypass grafts.
  • Documentation gaps may arise if prior surgical history is not clearly stated.
  • Billing challenges can occur if the clinical rationale for the use of this specific code is not well-supported.

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 I25.728 lies in its association with increased morbidity and potential for adverse cardiovascular events. Understanding this condition is crucial for managing population health, as it affects a significant number of patients with a history of coronary artery disease. Quality measures may focus on the timely diagnosis and management of angina in patients with grafts, influencing healthcare utilization patterns and resource allocation in cardiovascular care.

ICD-9 vs ICD-10

The clinical significance of I25.728 lies in its association with increased morbidity and potential for adverse cardiovascular events. Understanding this condition is crucial for managing population health, as it affects a significant number of patients with a history of coronary artery disease. Quality measures may focus on the timely diagnosis and management of angina in patients with grafts, influencing healthcare utilization patterns and resource allocation in cardiovascular care.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for the diagnosis is well-documented, as insurers may scrutinize claims for conditions involving grafts. Common denials may arise from insufficient documentation linking the diagnosis to the patient's current symptoms. Best practices include maintaining comprehensive records of patient encounters, diagnostic tests, and treatment plans to support the use of this code.

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 I25.728?

I25.728 covers atherosclerosis affecting coronary artery bypass grafts, specifically when patients experience other forms of angina pectoris, which may include stable or unstable angina.

When should I25.728 be used instead of related codes?

I25.728 should be used when there is documented atherosclerosis of bypass grafts along with symptoms of angina, differentiating it from codes that do not specify graft involvement.

What documentation supports I25.728?

Documentation should include a detailed patient history of coronary artery disease, prior bypass surgeries, current symptoms of angina, and results from diagnostic tests that confirm graft involvement.