Cardiology Coding Alert

Question: Can you help me better understand when it is appropriate to code I25.11 versus I25.10? I’m new to cardiology and don’t really get the difference between the different codes.

California Subscriber

Answer: These are both codes you would use to report atherosclerosis.

Code I25.10: If the patient has atherosclerosis of the native coronary artery without angina pectoris, then you would choose I25.10 (Atherosclerotic heart disease of native coronary artery without angina pectoris). Atherosclerotic heart disease (NOS) is an included condition for I25.10.

Codes from I25.11- series: If, however, the patient also experiences angina pectoris with the atherosclerosis , you may look to I25.11- (Atherosclerotic heart disease of native coronary artery with angina pectoris).

Code I25.11- requires a sixth character, so your choices become even narrower. Check out the options:

• I25.110 (Atherosclerotic heart disease of native coronary artery with unstable angina pectoris)
• I25.111 (Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm)
• I25.118 (Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris)
• I25.119 (Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris). Included conditions for this code are: atherosclerotic heart disease with angina NOS and atherosclerotic heart disease with ischemic chest pain.

Don’t miss these documentation details: You must confirm in the medical documentation the specific area of the atherosclerosis — whether it is within the native artery or documented to be within the artery or vein graft. You must also confirm if angina pectoris and if so, what type. You must also pay attention to if the cardiologist mentions spasm, as well.