2025 ICD-10-CM code I25.811
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Ischemic heart diseases - Atherosclerosis of other coronary vessels without angina pectoris Diseases of the circulatory system (I00-I99) Feed
Atherosclerosis of the native coronary artery in a transplanted heart without angina pectoris.
Medical necessity is established by evidence of significant atherosclerosis in the native coronary artery of the transplanted heart, confirmed by appropriate diagnostic testing and documented in the medical record. The absence of angina pectoris, while clinically significant in the coding choice, does not diminish the need for the diagnosis and management of atherosclerosis, as it can still lead to serious complications.The severity of the atherosclerosis and the risk of future cardiac events need to be carefully considered.
Cardiologist or other qualified healthcare professional responsible for diagnosing and managing cardiovascular conditions.The physician needs to evaluate the patient's cardiac status, conduct appropriate investigations (e.g., angiography, cardiac imaging), and determine the need for medical or interventional management based on the severity of the atherosclerosis and presence of any associated symptoms. The responsibility also involves the follow-up care, management of risk factors, and prevention of complications.
In simple words: This code describes a hardening of the arteries in the original heart that was transplanted.This hardening doesn't cause chest pain.
This code, I25.811, signifies atherosclerosis affecting the native coronary artery of a heart that has undergone transplantation, without the presence of angina pectoris (chest pain).It specifically refers to the build-up of plaque within the artery, narrowing it and reducing blood flow, but without the characteristic symptom of angina.The code is used when the patient exhibits atherosclerosis in their native coronary artery post-transplant, but doesn't experience angina.Additional codes may be necessary to specify the type of atherosclerosis (e.g., due to lipid-rich plaque or calcified lesion) or other co-occurring conditions.
Example 1: A 60-year-old male patient, 2 years post-heart transplant, presents with elevated cardiac enzymes and reduced ejection fraction.Cardiac catheterization reveals significant atherosclerosis in the native coronary artery, but the patient reports no angina.Code I25.811 is applied., A 55-year-old female patient underwent a heart transplant 5 years ago. Routine follow-up echocardiogram reveals evidence of significant atherosclerosis in the native coronary artery.The patient reports no chest pain or other related symptoms.Code I25.811 is utilized., A 70-year-old male, 1 year post-transplant, experiences shortness of breath on exertion.Diagnostic testing shows moderate atherosclerosis in the native coronary artery and mild angina.I25.75 (atherosclerosis of native coronary artery of transplanted heart with angina pectoris) would be more appropriate than I25.811 in this case, since the patient experiences angina.
Detailed history and physical examination, including symptoms and risk factors for cardiovascular disease; cardiac catheterization report documenting the presence and severity of atherosclerosis in the native coronary artery of the transplanted heart; results of other relevant diagnostic tests such as echocardiography, coronary angiography, and cardiac enzyme levels; and documentation confirming absence of angina pectoris.
** This code is highly specific and requires careful review of the clinical documentation to ensure its appropriate application.The absence of angina is a crucial differentiating factor from other related codes.
- Payment Status: Active
- Specialties:Cardiology, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office