I25.111 ICD-10-CM Code: Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.111 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Ischemic heart diseases (I20-I25)
I25.111
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
Narrowing of heart arteries due to plaque buildup causing chest pain that is triggered by artery spasms and has been documented.
Buddy Insight
This combination code captures atherosclerotic heart disease of native coronary arteries with vasospastic (Prinzmetal's) angina.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
Context neededHCC 88
Coefficient needs member context
RXHCC
Context neededHCC 188
Coefficient needs member context
Code Book Path
Inclusion Terms
Official- Atherosclerotic cardiovascular diseaseInherited from I25.1
- Coronary (artery) atheromaInherited from I25.1
- Coronary (artery) atherosclerosisInherited from I25.1
- Coronary (artery) diseaseInherited from I25.1
- Coronary (artery) sclerosisInherited from I25.1
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from I00-I99, I25, I25.1
- certain infectious and parasitic diseases (A00-B99)Inherited from I00-I99, I25, I25.1
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from I00-I99, I25, I25.1
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from I00-I99, I25, I25.1
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from I00-I99, I25, I25.1
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from I00-I99, I25, I25.1
- neoplasms (C00-D49)Inherited from I00-I99, I25, I25.1
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from I00-I99, I25, I25.1
- systemic connective tissue disorders (M30-M36)Inherited from I00-I99, I25, I25.1
- transient cerebral ischemic attacks and related syndromes (G45.-)Inherited from I00-I99, I25, I25.1
- non-ischemic myocardial injury (I5A)Inherited from I00-I99, I25, I25.1
- atheroembolism (I75.-)Inherited from I00-I99, I25, I25.1
- atherosclerosis of coronary artery bypass graft(s) and transplanted heart (I25.7-)Inherited from I00-I99, I25, I25.1
Related Codes
Includes
OfficialNo Includes notes are included in this display for I25.111. Check the code and parent instructions in the Code Book.
Excludes 1
Official- angina pectoris with documented spasm without atherosclerotic heart disease (I20.1)
Code First
OfficialNo Code First sequencing instructions are included in this display for I25.111. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify:Inherited from I25, I25.1
- chronic total occlusion of coronary artery (I25.82)Inherited from I25, I25.1
- exposure to environmental tobacco smoke (Z77.22)Inherited from I25, I25.1
- history of tobacco dependence (Z87.891)Inherited from I25, I25.1
- occupational exposure to environmental tobacco smoke (Z57.31)Inherited from I25, I25.1
- tobacco dependence (F17.-)Inherited from I25, I25.1
- tobacco use (Z72.0)Inherited from I25, I25.1
- code, if applicable, to identify:Inherited from I25, I25.1
- coronary atherosclerosis due to calcified coronary lesion (I25.84)Inherited from I25, I25.1
- coronary atherosclerosis due to lipid rich plaque (I25.83)Inherited from I25, I25.1
Code Also
Official- the presence of hypertension (I10-I1A)Inherited from I20-I25
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 I25.111 an HCC code?
I25.111 has no mapping under the current CMS-HCC V28 community payment model. I25.111 has a separate mapping under the CMS-HCC ESRD model (HCC 88 (Angina Pectoris)) and the Part D RxHCC model (HCC 188 (Coronary Artery Disease)); the applicable result needs member context.
- Code
- I25.111
- Description
- Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
I25.111 is the ICD-10-CM diagnosis code for atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm. Narrowing of heart arteries due to plaque buildup causing chest pain that is triggered by artery spasms and has been documented. I25.111 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering ischemic heart diseases (i20-i25).
I25.111 has no mapping under the current CMS-HCC V28 community payment model. I25.111 has a separate mapping under the CMS-HCC ESRD model (HCC 88 (Angina Pectoris)) and the Part D RxHCC model (HCC 188 (Coronary Artery Disease)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Native-artery CAD with angina pectoris and documented spasm. The provider must link coronary spasm to the angina, a positive provocation test, Prinzmetal-type description, or explicit 'vasospastic angina with CAD' statement in the assessment.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I25.111 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Native-artery CAD with angina pectoris and documented spasm. The provider must link coronary spasm to the angina, a positive provocation test, Prinzmetal-type description, or explicit 'vasospastic angina with CAD' statement in the assessment.
- •Do not use I25.111 for routine exertional angina, that is I25.118 or I25.119. The spasm descriptor is a specific clinical finding, not a catch-all for atypical chest pain.
- •Only unstable angina (I25.110) pulls native-vessel CAD into HCC 229; CAD with documented spasm, with other angina, or with unspecified angina (I25.111/118/119) carries no V28 coefficient.
Clinical Significance
This combination code captures atherosclerotic heart disease of native coronary arteries with vasospastic (Prinzmetal's) angina. Vasospastic angina is caused by coronary artery spasm superimposed on atherosclerotic disease and can cause transient ST elevation and significant ischemia. The documented spasm distinction is clinically important because treatment differs from typical stable angina, often requiring calcium channel blockers and avoidance of beta-blockers.
Documentation Requirements
- ✓Documentation of atherosclerotic coronary artery disease involving native vessels
- ✓Explicit documentation of coronary artery spasm (vasospastic or Prinzmetal's angina)
- ✓Objective evidence of spasm (transient ST elevation, angiographic spasm provocation testing)
- ✓Clinical presentation including timing and character of anginal episodes
- ✓Treatment plan including calcium channel blockers and/or long-acting nitrates
Excludes 1, Do NOT code together
- angina pectoris with documented spasm without atherosclerotic heart disease (I20.1)
Commonly Confused Codes
- •I25.110: Same condition with unstable angina: unstable angina without documented spasm
- •I20.1: Angina pectoris with documented spasm: vasospastic angina without documented coronary artery disease
- •I25.118: Same condition with other forms of angina: for angina types other than spasm, unstable, or refractory
- •I25.119: Same condition with unspecified angina: when the angina type is not documented