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ICD-10 Guide
ICD-10 CodesI25.738

I25.738

Billable

Atherosclerosis of nonautologous biological 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 I25.738 is a billable code used to indicate a diagnosis of atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris.

Key Diagnostic Point:

I25.738 refers to atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris. This condition involves the progressive buildup of plaque within the grafts used in coronary artery bypass surgery, leading to reduced blood flow to the heart muscle. Clinically, patients may present with symptoms of angina pectoris, which can manifest as chest pain, discomfort, or pressure, particularly during physical exertion or emotional stress. The anatomy involved includes the coronary arteries and the grafts, which may be derived from biological sources such as veins or arteries from other parts of the body. Disease progression can lead to ischemic heart disease, heart failure, or myocardial infarction if not managed appropriately. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as angiography or stress testing to assess graft patency and coronary artery status. The identification of this specific code is crucial for accurate representation of the patient's condition and for guiding treatment options.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of graft pathology and angina types.
  • Treatment complexity: May involve multiple treatment modalities including medication management and potential re-intervention.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other forms of coronary artery disease.

Audit Risk Factors

  • Common coding errors: Misidentification of graft-related issues versus native artery disease.
  • Documentation gaps: Incomplete records regarding the patient's surgical history and current symptoms.
  • 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

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 I25.738 lies in its association with increased morbidity and potential mortality due to heart disease. Understanding this condition is crucial for improving population health outcomes, as it affects a significant number of patients with a history of coronary artery bypass grafting. Quality measures may include monitoring the incidence of angina and re-intervention rates, while healthcare utilization patterns may reflect the need for ongoing management of patients with graft-related atherosclerosis.

ICD-9 vs ICD-10

The clinical significance of I25.738 lies in its association with increased morbidity and potential mortality due to heart disease. Understanding this condition is crucial for improving population health outcomes, as it affects a significant number of patients with a history of coronary artery bypass grafting. Quality measures may include monitoring the incidence of angina and re-intervention rates, while healthcare utilization patterns may reflect the need for ongoing management of patients with graft-related atherosclerosis.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for procedures and treatments is well-documented. Common denials may arise from insufficient documentation linking the diagnosis to the treatment provided. Best practices include maintaining comprehensive records of patient history, diagnostic tests, and treatment plans to support claims effectively.

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 I25.738?

I25.738 covers atherosclerosis affecting nonautologous biological coronary artery bypass grafts, specifically when patients experience other forms of angina pectoris, which may include stable angina, unstable angina, or variant angina.

When should I25.738 be used instead of related codes?

I25.738 should be used when the patient has a documented history of coronary artery bypass grafting with subsequent atherosclerosis of the grafts and presents with symptoms of angina. It is important to differentiate this from native coronary artery disease codes.

What documentation supports I25.738?

Documentation should include the patient's surgical history, current symptoms of angina, results from diagnostic tests (such as angiograms), and any treatment plans that reflect the management of graft-related atherosclerosis.