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ICD-10 Guide
ICD-10 CodesI25.84

I25.84

Billable

Coronary atherosclerosis due to calcified coronary lesion

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

Code Description

ICD-10 I25.84 is a billable code used to indicate a diagnosis of coronary atherosclerosis due to calcified coronary lesion.

Key Diagnostic Point:

Coronary atherosclerosis due to calcified coronary lesion is characterized by the buildup of calcium deposits within the coronary arteries, leading to the hardening and narrowing of these vessels. This condition often presents with symptoms such as chest pain (angina), shortness of breath, and fatigue, particularly during physical exertion. The anatomy involved includes the coronary arteries, which supply blood to the heart muscle. Over time, the calcification can exacerbate atherosclerosis, increasing the risk of myocardial infarction (heart attack) and other cardiovascular events. Disease progression may be asymptomatic initially but can lead to significant ischemic heart disease if left untreated. Diagnostic considerations include imaging studies such as coronary angiography, CT scans, and stress tests to evaluate the extent of coronary artery disease and the presence of calcified lesions. Clinicians must assess risk factors such as hypertension, diabetes, hyperlipidemia, and smoking history to manage and treat this condition effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm calcified lesions.
  • Treatment complexity: May involve lifestyle changes, medications, and possibly invasive procedures.
  • Documentation requirements: Detailed clinical history and imaging results are necessary for accurate coding.
  • Coding specificity: Requires precise documentation to differentiate from other forms of coronary artery disease.

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 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I25.84 lies in its association with increased morbidity and mortality due to cardiovascular events. Understanding this condition is crucial for population health, as it affects a significant portion of the aging population. Quality measures related to the management of coronary artery disease often include monitoring and treatment of patients with calcified lesions. Healthcare utilization patterns indicate that early diagnosis and intervention can reduce hospitalizations and improve patient outcomes, highlighting the importance of accurate coding and documentation in managing this prevalent condition.

ICD-9 vs ICD-10

The clinical significance of I25.84 lies in its association with increased morbidity and mortality due to cardiovascular events. Understanding this condition is crucial for population health, as it affects a significant portion of the aging population. Quality measures related to the management of coronary artery disease often include monitoring and treatment of patients with calcified lesions. Healthcare utilization patterns indicate that early diagnosis and intervention can reduce hospitalizations and improve patient outcomes, highlighting the importance of accurate coding and documentation in managing this prevalent condition.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of demonstrating medical necessity for diagnostic tests and treatments. Common denials may arise from insufficient documentation or lack of clarity in the clinical rationale for the diagnosis. Coding best practices recommend using the most specific code available and ensuring that the documentation aligns with the services billed.

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 I25.84?

I25.84 specifically covers coronary atherosclerosis that is attributed to calcified lesions in the coronary arteries, which may lead to ischemic heart disease and related complications.

When should I25.84 be used instead of related codes?

I25.84 should be used when there is clear evidence of calcified lesions contributing to coronary atherosclerosis, differentiating it from other forms of coronary artery disease that may not involve calcification.

What documentation supports I25.84?

Documentation should include imaging studies that confirm the presence of calcified lesions, clinical symptoms, and a comprehensive assessment of risk factors contributing to coronary artery disease.