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ICD-10 Guide
ICD-10 CodesI25.712

I25.712

Billable

Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris

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

Code Description

ICD-10 I25.712 is a billable code used to indicate a diagnosis of atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris.

Key Diagnostic Point:

I25.712 refers to atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris. This condition arises when atherosclerosis, characterized by the buildup of plaque in the arteries, affects the grafts used in coronary artery bypass surgery. Patients typically present with refractory angina pectoris, which is chest pain that persists despite treatment, indicating inadequate blood flow to the heart muscle. The anatomy involved includes the coronary arteries and the grafts, which are often segments of the patient's own veins, such as the saphenous vein. Disease progression can lead to worsening angina, heart failure, or myocardial infarction if not managed appropriately. Diagnostic considerations include a thorough clinical evaluation, imaging studies like angiography, and functional assessments such as stress tests to determine the severity of ischemia. The presence of refractory angina suggests a significant compromise in coronary perfusion, necessitating careful monitoring and potential intervention.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the type of graft or the severity of angina.
  • Documentation gaps may arise if the refractory nature of angina is not clearly stated.
  • Billing challenges can occur if the clinical rationale for the use of this specific code is not well supported.

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 I25.712 lies in its association with severe cardiovascular morbidity, impacting patient quality of life and increasing healthcare utilization due to frequent hospitalizations for angina management. Understanding this condition is crucial for population health, as it highlights the need for effective management strategies for patients with a history of coronary artery bypass grafting. Epidemiologically, the prevalence of atherosclerosis in grafts underscores the importance of monitoring and preventive measures in at-risk populations.

ICD-9 vs ICD-10

The clinical significance of I25.712 lies in its association with severe cardiovascular morbidity, impacting patient quality of life and increasing healthcare utilization due to frequent hospitalizations for angina management. Understanding this condition is crucial for population health, as it highlights the need for effective management strategies for patients with a history of coronary artery bypass grafting. Epidemiologically, the prevalence of atherosclerosis in grafts underscores the importance of monitoring and preventive measures in at-risk populations.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for the procedure is clearly documented, as well as any associated treatments or interventions. Common denials may arise from insufficient documentation or failure to demonstrate the refractory nature of angina. Coding best practices emphasize the importance of specificity in documentation to support the use of this code and to avoid potential 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 I25.712?

I25.712 specifically covers cases of atherosclerosis affecting autologous vein grafts used in coronary artery bypass surgery, where patients experience refractory angina pectoris, indicating severe ischemic heart disease.

When should I25.712 be used instead of related codes?

I25.712 should be used when the patient has a documented history of coronary artery bypass grafting with subsequent atherosclerosis affecting the grafts and is experiencing refractory angina, distinguishing it from other forms of angina or atherosclerosis.

What documentation supports I25.712?

Documentation should include a detailed history of the patient's coronary artery disease, specifics of the bypass grafts used, evidence of refractory angina through clinical notes, and results from diagnostic tests confirming graft involvement.