I25.110
BillableAtherosclerotic heart disease of native coronary artery with unstable angina pectoris
HCC Category Mapping
V28HCC 229 — Unstable Angina and Other Acute Ischemic Heart Disease
0.000V24HCC 87 — Unstable Angina and Other Acute Ischemic Heart Disease
0.274ESRDHCC 87 — Unstable Angina and Other Acute Ischemic Heart Disease
0.000RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
Hardening of the heart's blood vessels with unstable chest pain, indicating a more serious form of coronary artery disease.
Coding Tips
- •Unstable angina indicates higher risk; ensure documentation distinguishes unstable from stable angina
- •This code requires both atherosclerotic disease AND unstable angina to be documented
Clinical Significance
Atherosclerotic heart disease of native coronary artery with unstable angina is a critical combination code that captures both the underlying coronary artery disease and the acute anginal presentation. Unstable angina indicates a high risk of imminent myocardial infarction and requires urgent medical attention. This code is significantly more valuable for risk adjustment than coronary artery disease without angina, mapping to HCC 87.
Documentation Requirements
- ✓Documentation of atherosclerotic coronary artery disease involving native vessels
- ✓Explicit documentation of 'unstable angina' (new onset, crescendo pattern, or angina at rest)
- ✓Clinical description distinguishing unstable from stable angina
- ✓Diagnostic workup (troponin to rule out myocardial infarction, electrocardiogram)
- ✓Treatment plan including antianginal and antiplatelet therapy
- ✓No evidence of myocardial necrosis (troponin negative or stable)
Excludes 1 — Do NOT code together
- unstable angina without atherosclerotic heart disease (I20.0)
Commonly Confused Codes
I25.10 — Atherosclerotic heart disease of native coronary artery without angina: no angina present, no HCC valueI25.119 — Same condition with unspecified angina: less specific angina documentationI25.111 — Same condition with documented spasm: vasospastic angina specifically documentedI20.0 — Unstable angina without documented coronary artery disease: use when coronary artery disease is not confirmedI21.4 — Non-ST elevation myocardial infarction: if troponin is elevated, consider myocardial infarction instead
Code Hierarchy
└I25Chronic ischemic heart disease└I25.1Atherosclerotic heart disease of native coronary artery└I25.11Atherosclerotic heart disease of native coronary artery with angina pectoris└I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
└I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris