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ICD-10 Guide
ICD-10 CodesI25.752

I25.752

Billable

Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris

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

Code Description

ICD-10 I25.752 is a billable code used to indicate a diagnosis of atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris.

Key Diagnostic Point:

I25.752 refers to atherosclerosis of the native coronary artery of a transplanted heart, specifically in patients experiencing refractory angina pectoris. This condition arises when there is a buildup of plaque in the coronary arteries, which can lead to reduced blood flow to the heart muscle, particularly in individuals who have undergone heart transplantation. The anatomy involved includes the native coronary arteries that supply blood to the heart, which may become narrowed or blocked due to atherosclerosis. Disease progression can be insidious, often leading to symptoms such as chest pain or discomfort (angina) that does not respond to standard treatments. 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. The presence of refractory angina indicates that the patient's symptoms persist despite optimal medical therapy, necessitating careful management and potential intervention.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of post-transplant cardiac function and atherosclerotic changes.
  • Treatment complexity: Management may involve multiple specialties, including cardiology and transplant surgery.
  • Documentation requirements: Detailed clinical documentation is essential to support the diagnosis and treatment plan.
  • Coding specificity: High specificity is required to accurately capture the nuances of the condition.

Audit Risk Factors

  • Common coding errors: Misclassification of angina types or failure to document the refractory nature.
  • Documentation gaps: Incomplete records regarding the patient's history and treatment response.
  • Billing challenges: Potential denials due to insufficient documentation supporting the severity and complexity of the condition.

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

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I25.752 lies in its association with increased morbidity and potential mortality in heart transplant recipients. Understanding this condition is crucial for improving patient outcomes and managing healthcare resources effectively. The population health impact includes a need for ongoing monitoring and management of cardiovascular health in transplant patients, as well as the importance of quality measures that focus on reducing the incidence of refractory angina and improving overall heart function. Epidemiologically, this condition highlights the challenges faced by transplant recipients in maintaining cardiovascular health post-surgery.

ICD-9 vs ICD-10

The clinical significance of I25.752 lies in its association with increased morbidity and potential mortality in heart transplant recipients. Understanding this condition is crucial for improving patient outcomes and managing healthcare resources effectively. The population health impact includes a need for ongoing monitoring and management of cardiovascular health in transplant patients, as well as the importance of quality measures that focus on reducing the incidence of refractory angina and improving overall heart function. Epidemiologically, this condition highlights the challenges faced by transplant recipients in maintaining cardiovascular health post-surgery.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for any procedures performed is clearly documented. Common denials may arise from insufficient evidence of the refractory nature of the angina or lack of detailed clinical notes. Best practices include maintaining comprehensive records of patient evaluations, treatment responses, and any interventions undertaken, as well as ensuring that coding aligns with the documentation provided.

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 I25.752?

I25.752 covers atherosclerosis affecting the native coronary arteries of a transplanted heart, specifically in patients who experience refractory angina pectoris, which is chest pain that persists despite treatment.

When should I25.752 be used instead of related codes?

I25.752 should be used when a patient with a transplanted heart presents with refractory angina due to atherosclerosis of the native coronary arteries, distinguishing it from cases without refractory symptoms.

What documentation supports I25.752?

Documentation should include a detailed patient history, evidence of atherosclerosis through imaging studies, and notes on the patient's response to treatment for angina, emphasizing the refractory nature of the symptoms.