I25.110 ICD-10-CM Code: Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.110 maps to CMS-HCC V28 229 (RAF 0.240). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Ischemic heart diseases (I20-I25)
I25.110
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtherosclerotic heart disease of native coronary artery with unstable angina pectoris
Hardening of the heart's blood vessels with unstable chest pain, indicating a more serious form of coronary artery disease.
Buddy Insight
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.
CMS-HCC V28
MappedHCC 229
RAF 0.240
CMS-HCC V24
MappedHCC 87
RAF 0.195
ACA/HHS
MappedHCC 132
Varies by metal level
ESRD/PACE
MappedHCC 87
RAF 0.120
RXHCC
MappedHCC 188
RAF 0.052
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I25.110 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I25.110 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I25.110 in this effective period.
Excludes 1
Official- unstable angina without atherosclerotic heart disease (I20.0)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I25.110 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I25.110 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I25.110 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is I25.110 an HCC code?
Yes. I25.110 (Atherosclerotic heart disease of native coronary artery with unstable angina pectoris) maps to Unstable Angina and Other Acute Ischemic Heart Disease under the CMS-HCC V28 risk adjustment model (and Unstable Angina and Other Acute Ischemic Heart Disease under V24), with a community non-dual aged RAF of 0.240. It is billable for payment year 2026.
Coder answer: I25.110 is billable and maps to V28 HCC 229, Unstable Angina and Other Acute Ischemic Heart Disease. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- I25.110
- Description
- Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
- HCC (V28)
- HCC 229 — Unstable Angina and Other Acute Ischemic Heart Disease
- RAF
- 0.240
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work I25.110 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I25.110
For I25.110 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I25.110 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I25.110 is the ICD-10-CM diagnosis code for atherosclerotic heart disease of native coronary artery with unstable angina pectoris. Hardening of the heart's blood vessels with unstable chest pain, indicating a more serious form of coronary artery disease. I25.110 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering ischemic heart diseases (i20-i25).
Under the CMS-HCC V28 risk adjustment model, I25.110 maps to Unstable Angina and Other Acute Ischemic Heart Disease (HCC 229) with a community, non-dual, aged base RAF weight of 0.240. Under the older V24 model, I25.110 mapped to the same category but with a base RAF weight of 0.195, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Documentation must establish ASHD of a native coronary artery with unstable angina. Provider narrative needs both the atherosclerotic etiology and the unstable-angina descriptor, rest pain, crescendo pattern, or new-onset angina with a workup in progress all support the unstable designation. Because I25.110 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I25.110 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Documentation must establish ASHD of a native coronary artery with unstable angina. Provider narrative needs both the atherosclerotic etiology and the unstable-angina descriptor, rest pain, crescendo pattern, or new-onset angina with a workup in progress all support the unstable designation.
- •Do not report I20.0 (unstable angina) separately, the combination code I25.110 includes both components per ICD-10-CM instruction. Also, once the unstable pattern resolves and angina stabilizes, the follow-up code shifts to I25.111 or I25.119.
- •V28 HCC 229 (Unstable Angina and Other Acute Ischemic Heart Disease) at RAF 0.24. Unstable angina is the descriptor that pulls native-vessel CAD into a payment HCC; the underlying atherosclerosis without angina (I25.10) carries none.
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 value
- •I25.119: Same condition with unspecified angina: less specific angina documentation
- •I25.111: Same condition with documented spasm: vasospastic angina specifically documented
- •I20.0: Unstable angina without documented coronary artery disease: use when coronary artery disease is not confirmed
- •I21.4: Non-ST elevation myocardial infarction: if troponin is elevated, consider myocardial infarction instead