ICD-10 Coding for Coronary Heart Disease(I25.10, I25.11)
Complete ICD-10-CM coding and documentation guide for Coronary Heart Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Coronary Heart Disease
I20-I25Primary Range
Ischemic Heart Diseases
This range includes all codes related to coronary heart disease, including angina and myocardial infarction.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | Use when atherosclerosis is present in native coronary arteries without angina symptoms. |
|
| I25.11 | Atherosclerotic heart disease of native coronary artery with angina pectoris | Use when atherosclerosis is present in native coronary arteries with angina symptoms. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for coronary heart disease
Essential facts and insights about Coronary Heart Disease
Primary ICD-10-CM Codes for coronary heart disease
Decision Criteria
clinical Criteria
- Confirmed coronary artery atherosclerosis without angina symptoms
Applicable To
- Coronary artery disease without angina
Excludes
- Atherosclerotic heart disease with angina pectoris (I25.11-)
Clinical Validation Requirements
- Coronary angiography confirming atherosclerosis
- Absence of angina symptoms
Code-Specific Risks
- Misclassification if angina is present but not documented
Coding Notes
- Ensure documentation clearly states absence of angina.
I25.11 - Atherosclerotic heart disease of native coronary artery with angina pectoris
Use when atherosclerosis is present in native coronary arteries with angina symptoms.
Applicable To
- Coronary artery disease with angina
Excludes
- Atherosclerotic heart disease without angina pectoris (I25.10)
Clinical Validation Requirements
- Documented angina symptoms
- Coronary angiography confirming atherosclerosis
Coding Notes
Specify type of angina in documentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Coronary Heart Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I25.10.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential loss in reimbursement.
Mitigation Strategy
Train staff on documentation standards, Use templates that prompt for angina type
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use I25.11 when angina is present.
Impact
Inadequate documentation of angina type can lead to audit issues.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Coronary Heart Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Coronary Heart Disease
Use these documentation templates to ensure complete and accurate documentation for Coronary Heart Disease. These templates include all required elements for proper coding and billing.
Patient with stable angina and CAD
Specialty: CardiologyRequired Elements
- Angina type
- Coronary angiography results
- Medication adherence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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