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ICD-10 Guide
ICD-10 CodesI25.769

I25.769

Billable

Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris

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

Code Description

ICD-10 I25.769 is a billable code used to indicate a diagnosis of atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris.

Key Diagnostic Point:

I25.769 refers to atherosclerosis of a bypass graft of the coronary artery in a transplanted heart, accompanied by unspecified angina pectoris. This condition arises when there is a buildup of plaque within the grafted arteries, leading to narrowed or blocked blood flow. The clinical presentation may include chest pain or discomfort, which can vary in intensity and frequency. The anatomy involved primarily includes the coronary arteries that have been surgically bypassed during heart transplantation. Disease progression can lead to ischemic heart disease, heart failure, or other serious cardiovascular complications if left untreated. Diagnostic considerations include patient history, physical examination, and imaging studies such as angiography or stress tests to assess graft patency and blood flow. It is crucial to differentiate this condition from other forms of angina and coronary artery disease to ensure appropriate management and treatment strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation of graft status and symptoms.
  • Treatment complexity: May involve medication management, lifestyle changes, or surgical interventions.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other cardiovascular conditions.

Audit Risk Factors

  • Common coding errors: Misidentifying the type of angina or graft involvement.
  • Documentation gaps: Incomplete records regarding patient history or treatment plans.
  • Billing challenges: Potential denials due to lack of specificity in documentation.

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 I25.769 lies in its potential to lead to serious cardiovascular events if not managed appropriately. Understanding this condition is vital for improving population health outcomes, as it affects patients with a history of heart transplantation who are at increased risk for complications. Quality measures may include monitoring graft patency and managing angina symptoms effectively, which can influence healthcare utilization patterns and overall patient care strategies.

ICD-9 vs ICD-10

The clinical significance of I25.769 lies in its potential to lead to serious cardiovascular events if not managed appropriately. Understanding this condition is vital for improving population health outcomes, as it affects patients with a history of heart transplantation who are at increased risk for complications. Quality measures may include monitoring graft patency and managing angina symptoms effectively, which can influence healthcare utilization patterns and overall patient care strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity is clearly established through clinical documentation. Common denials may arise from insufficient detail regarding the patient's condition or lack of evidence supporting the diagnosis. Best practices include maintaining thorough records of patient evaluations, treatment plans, and follow-up care to facilitate smooth billing processes.

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 I25.769?

I25.769 covers atherosclerosis affecting bypass grafts in patients with a transplanted heart, specifically when accompanied by unspecified angina pectoris. It does not include other types of coronary artery disease or native artery involvement.

When should I25.769 be used instead of related codes?

I25.769 should be used when the patient has a documented history of atherosclerosis affecting a bypass graft in a transplanted heart, particularly when symptoms of angina are present but not specifically classified.

What documentation supports I25.769?

Documentation should include a detailed patient history, evidence of graft involvement through imaging studies, and clinical notes indicating the presence of angina symptoms. Clear differentiation from other cardiovascular conditions is essential.