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ICD-10 Guide
ICD-10 CodesI25.81

I25.81

Non-billable

Atherosclerosis of other coronary vessels without angina pectoris

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

Code Description

ICD-10 I25.81 is a used to indicate a diagnosis of atherosclerosis of other coronary vessels without angina pectoris.

Key Diagnostic Point:

I25.81 refers to atherosclerosis of other coronary vessels without angina pectoris, a condition characterized by the buildup of plaque in the coronary arteries that are not the left main coronary artery or the right coronary artery. This condition can lead to reduced blood flow to the heart muscle, potentially resulting in ischemia. Clinically, patients may present with symptoms such as shortness of breath, fatigue, or atypical chest pain, but without the classic angina pectoris. The anatomy involved includes the smaller branches of the coronary arteries, which may not be as commonly affected as the major vessels. Disease progression can vary; some patients may remain asymptomatic for years, while others may experience significant cardiovascular events. Diagnostic considerations include imaging studies such as coronary angiography, CT angiography, or stress testing to assess the extent of coronary artery disease. It is crucial to differentiate this condition from other forms of coronary artery disease, particularly those that present with angina, to ensure appropriate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: Management may involve lifestyle changes, medications, and possibly interventional procedures.
  • Documentation requirements: Detailed clinical history and diagnostic findings are necessary for accurate coding.
  • Coding specificity: Requires precise identification of affected vessels and absence of angina.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of coronary artery disease.
  • Documentation gaps: Incomplete clinical history or lack of imaging results.
  • Billing challenges: Potential denials if the 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

The clinical significance of I25.81 lies in its potential to lead to serious cardiovascular events, impacting population health through increased morbidity and healthcare utilization. Understanding this condition is crucial for quality measures aimed at reducing cardiovascular disease incidence. Epidemiologically, atherosclerosis is a leading cause of death globally, making awareness and accurate coding essential for effective healthcare planning and resource allocation.

ICD-9 vs ICD-10

The clinical significance of I25.81 lies in its potential to lead to serious cardiovascular events, impacting population health through increased morbidity and healthcare utilization. Understanding this condition is crucial for quality measures aimed at reducing cardiovascular disease incidence. Epidemiologically, atherosclerosis is a leading cause of death globally, making awareness and accurate coding essential for effective healthcare planning and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by appropriate imaging studies and clinical evaluations. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services rendered. Best practices include maintaining comprehensive records of patient assessments, imaging results, and treatment plans to support the coding and billing process.

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 I25.81?

I25.81 covers atherosclerosis affecting other coronary vessels, specifically those not classified under major coronary arteries, and does not include cases with angina pectoris. It may include conditions like silent ischemia or asymptomatic coronary artery disease.

When should I25.81 be used instead of related codes?

I25.81 should be used when a patient has documented atherosclerosis of coronary vessels without any symptoms of angina. It is important to differentiate it from codes that include angina or other symptomatic presentations.

What documentation supports I25.81?

Documentation should include a thorough clinical evaluation, imaging results showing atherosclerosis in the specified vessels, and a clear statement that the patient does not experience angina pectoris.