I25.111
BillableAtherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
HCC Category Mapping
V24HCC 88 — Angina Pectoris
0.000ESRDHCC 88 — Angina Pectoris
0.000RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
Narrowing of heart arteries due to plaque buildup causing chest pain that is triggered by artery spasms and has been documented.
Coding Tips
- •Ensure documentation specifically mentions vasospastic angina or Prinzmetal's angina with evidence of spasm (EKG changes, angiography findings)
- •This code requires confirmation of both atherosclerotic disease AND documented spasm; do not use if spasm is only suspected
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 spasmI20.1 — Angina pectoris with documented spasm: vasospastic angina without documented coronary artery diseaseI25.118 — Same condition with other forms of angina: for angina types other than spasm, unstable, or refractoryI25.119 — Same condition with unspecified angina: when the angina type is not documented
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└I25.111Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
└I25.111Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm