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v1.0.0
ICD-10 Guide
DiagnosesAtherosclerosis

Atherosclerosis

ICD-10 Coding for Atherosclerosis(I25.10, I70.2-)

PRIMARY SPECIALTYCardiology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Atherosclerosis?
Essential facts and insights about Atherosclerosis

Key Clinical Considerations:

  • Presence of symptoms such as chest pain (angina), shortness of breath, or fatigue during exertion.
  • Laboratory findings may include elevated cholesterol levels, particularly low-density lipoprotein (LDL) and triglycerides.
  • Physical examination may reveal signs of peripheral artery disease, such as diminished pulses or coolness in the extremities.
  • Imaging findings may include angiography showing narrowed arteries or ultrasound revealing plaque buildup.
  • Severity criteria may be assessed using the degree of arterial blockage or the presence of ischemic heart disease.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must include a clear diagnosis of atherosclerosis supported by clinical findings.
  • Specific terminology such as 'atherosclerotic cardiovascular disease' or 'peripheral artery disease' must be documented.
  • Examples include documenting the patient's symptoms, risk factors, and results of diagnostic tests.
  • Medical necessity must be established through documentation of symptoms and the need for diagnostic testing or treatment.
  • Quality measures may require documentation of risk factor management, such as blood pressure and cholesterol levels.

Coding Guidelines

Usage Guidelines & Examples

  • Use I25.10 for atherosclerosis of coronary arteries without angina; use I25.110 for stable angina due to atherosclerosis.
  • Do not use this code for atherosclerosis due to other causes, such as vasculitis or trauma.
  • Compare with I70.2- for atherosclerosis of the aorta, which may present similarly but affects different vascular territories.
  • Common errors include misclassifying the severity of the disease or failing to document associated conditions.
  • In complex cases, ensure to differentiate between stable and unstable angina to select the appropriate code.

Code Exclusions

Important Exclusions

  • Excludes conditions such as acute myocardial infarction (I21) and transient ischemic attack (G45).
  • Alternative codes for excluded conditions include I21 for acute coronary syndrome and I63 for cerebrovascular accidents.
  • Conditions are excluded due to differing pathophysiology and treatment approaches.
  • Common mistakes include coding atherosclerosis when the patient has an acute event that is better captured by a different code.
  • Related but distinct conditions include coronary artery disease and peripheral vascular disease.

Related ICD-10 Codes

Primary Codes
I25.10
Atherosclerotic heart disease, unspecified
I70.2
Atherosclerosis of native arteries of the extremities
Ancillary Codes
Z87.891
L97.5-
Differential Codes
I25.11-
E11.51

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Applies to patients with coronary artery disease, peripheral artery disease, and cerebrovascular disease.
  • Patient populations include adults, particularly those over 45 years, with risk factors such as smoking, obesity, and family history.
  • Clinical settings include outpatient cardiology clinics, inpatient hospital settings, and emergency departments.
  • Specialty-specific applications are relevant in cardiology, vascular surgery, and primary care.
  • Treatment contexts include lifestyle modification, pharmacotherapy, and surgical interventions.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with atherosclerosis based on clinical findings of chest pain and elevated LDL levels.'

Template 2

Template: 'Clinical presentation consistent with atherosclerosis including symptoms of intermittent claudication.'

Template 3

Template: 'Diagnostic criteria met as evidenced by angiography showing 70% blockage in the left anterior descending artery.'

Template 4

Template: 'Treatment plan initiated for atherosclerosis with lifestyle changes and statin therapy.'

Template 5

Template: 'Follow-up care for atherosclerosis including monitoring of lipid levels and blood pressure.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include clinical findings, risk factors, and results from diagnostic tests.

How does this differ from similar diagnoses?

Atherosclerosis is characterized by plaque buildup in arteries, while other conditions may involve different mechanisms.

What are common billing considerations?

Ensure that the diagnosis is supported by medical necessity and that all relevant codes are included for reimbursement.

What procedures are typically associated?

Common procedures include angioplasty, stenting, and bypass surgery, often coded with corresponding CPT codes.

Are there any quality reporting implications?

Quality measures may include monitoring of cholesterol levels, blood pressure, and lifestyle modifications.