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ICD-10 Guide
ICD-10 CodesI25.75

I25.75

Non-billable

Atherosclerosis of native coronary artery of transplanted heart with angina pectoris

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

Code Description

ICD-10 I25.75 is a used to indicate a diagnosis of atherosclerosis of native coronary artery of transplanted heart with angina pectoris.

Key Diagnostic Point:

I25.75 refers to atherosclerosis of the native coronary artery of a transplanted heart, which is a significant cardiovascular condition characterized by the buildup of plaque in the coronary arteries that supply blood to the heart muscle. This condition can lead to angina pectoris, a type of chest pain resulting from reduced blood flow to the heart. The anatomy involved includes the native coronary arteries that remain after heart transplantation, which can still be affected by atherosclerosis due to risk factors such as hyperlipidemia, hypertension, and diabetes. Disease progression may be insidious, often presenting with episodes of angina as the arterial lumen narrows, leading to ischemia. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as angiography or stress tests to assess coronary artery patency and function. Management typically involves lifestyle modifications, pharmacotherapy, and possibly revascularization procedures, depending on the severity of the disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of post-transplant cardiovascular changes and risk factors.
  • Treatment complexity: Involves multi-disciplinary approaches including cardiology and transplant specialists.
  • Documentation requirements: Detailed documentation of patient history, symptoms, and diagnostic tests is essential.
  • Coding specificity: Requires precise coding to differentiate from other forms of coronary artery disease.

Audit Risk Factors

  • Common coding errors: Misidentifying the condition as a general coronary artery disease without noting the transplant context.
  • Documentation gaps: Incomplete records regarding the patient's transplant history and current symptoms.
  • Billing challenges: Potential denials if the relationship between the transplant and atherosclerosis is not clearly established.

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

Transplant 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

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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 I25.75 lies in its association with increased morbidity and mortality in heart transplant recipients. Atherosclerosis can lead to significant complications, impacting population health by increasing the need for revascularization procedures and hospitalizations. Quality measures may focus on the management of cardiovascular risk factors in transplant patients, while healthcare utilization patterns may reflect the need for ongoing monitoring and intervention in this high-risk group. Epidemiologically, understanding the prevalence of atherosclerosis in transplanted hearts is crucial for improving long-term outcomes.

ICD-9 vs ICD-10

The clinical significance of I25.75 lies in its association with increased morbidity and mortality in heart transplant recipients. Atherosclerosis can lead to significant complications, impacting population health by increasing the need for revascularization procedures and hospitalizations. Quality measures may focus on the management of cardiovascular risk factors in transplant patients, while healthcare utilization patterns may reflect the need for ongoing monitoring and intervention in this high-risk group. Epidemiologically, understanding the prevalence of atherosclerosis in transplanted hearts is crucial for improving long-term outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the services provided, especially if revascularization procedures are performed. Common denials may arise from insufficient documentation of the transplant status or the relationship between the atherosclerosis and the patient's symptoms. Best practices include maintaining thorough records of all diagnostic tests and treatments related to the condition, as well as clear communication with payers regarding the complexity of care for transplant patients.

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 I25.75?

I25.75 specifically covers atherosclerosis affecting the native coronary arteries of a transplanted heart, leading to angina pectoris. It is essential to document the presence of angina and the history of heart transplantation.

When should I25.75 be used instead of related codes?

I25.75 should be used when the patient has a documented history of heart transplantation and presents with angina due to atherosclerosis of the native coronary arteries. It is crucial to differentiate it from other coronary artery disease codes that do not involve a transplant.

What documentation supports I25.75?

Documentation should include the patient's transplant history, current symptoms of angina, results from diagnostic tests such as angiography, and any relevant risk factors for atherosclerosis.