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ICD-10 Guide
ICD-10 CodesI25.119

I25.119

Billable

Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris

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

Code Description

ICD-10 I25.119 is a billable code used to indicate a diagnosis of atherosclerotic heart disease of native coronary artery with unspecified angina pectoris.

Key Diagnostic Point:

I25.119 refers to atherosclerotic heart disease of the native coronary artery with unspecified angina pectoris. This condition arises from the buildup of plaque within the coronary arteries, leading to reduced blood flow to the heart muscle. Clinically, patients may present with chest pain or discomfort, which may be triggered by physical exertion or emotional stress, although the angina is unspecified in this code. The anatomy involved includes the coronary arteries, which supply blood to the heart. Over time, atherosclerosis can progress, potentially leading to more severe conditions such as myocardial infarction (heart attack) or heart failure. Diagnostic considerations for I25.119 include a thorough patient history, physical examination, and diagnostic tests such as electrocardiograms (ECGs), stress tests, and coronary angiography to assess the extent of coronary artery disease and the presence of ischemia. It is crucial for healthcare providers to differentiate this code from other forms of heart disease, particularly when specifying the type of angina or other cardiovascular conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of symptoms and diagnostic tests.
  • Treatment complexity: May involve lifestyle modifications, medications, or surgical interventions.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis.
  • Coding specificity: Requires accurate coding to differentiate from other types of heart disease.

Audit Risk Factors

  • Common coding errors: Misclassification of angina type or failure to document the severity of symptoms.
  • Documentation gaps: Incomplete patient history or lack of diagnostic test results.
  • Billing challenges: Potential denials due to insufficient documentation supporting 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 I25.119 lies in its association with increased morbidity and mortality rates due to cardiovascular events. Atherosclerotic heart disease is a leading cause of death globally, impacting population health significantly. Quality measures often focus on the management of coronary artery disease, including lifestyle interventions and medication adherence. Understanding healthcare utilization patterns related to this condition can help improve patient outcomes and inform public health strategies.

ICD-9 vs ICD-10

The clinical significance of I25.119 lies in its association with increased morbidity and mortality rates due to cardiovascular events. Atherosclerotic heart disease is a leading cause of death globally, impacting population health significantly. Quality measures often focus on the management of coronary artery disease, including lifestyle interventions and medication adherence. Understanding healthcare utilization patterns related to this condition can help improve patient outcomes and inform public health strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for diagnostic tests and treatments is clearly documented. Common denials may arise from insufficient evidence of the diagnosis or failure to link the condition to the services provided. Best practices include maintaining thorough records of patient interactions, diagnostic findings, and treatment plans to support claims and reduce the risk of audits.

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 I25.119?

I25.119 covers atherosclerotic heart disease affecting the native coronary arteries, specifically when the patient experiences unspecified angina pectoris. This includes cases where the nature of the angina is not clearly defined, necessitating further evaluation.

When should I25.119 be used instead of related codes?

I25.119 should be used when a patient has a confirmed diagnosis of atherosclerotic heart disease with unspecified angina. It is important to differentiate it from codes that specify stable or unstable angina or other heart conditions.

What documentation supports I25.119?

Documentation for I25.119 should include a detailed patient history, clinical findings, results from diagnostic tests (like ECGs or stress tests), and any treatment plans. Clear documentation of symptoms and their impact on the patient's daily life is also essential.