I25.112 ICD-10-CM Code: Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
I25.112 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Ischemic heart diseases (I20-I25)
I25.112
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtherosclerotic heart disease of native coronary artery with refractory angina pectoris
Narrowing of heart arteries causing severe chest pain that does not respond adequately to standard angina medications.
Buddy Insight
Atherosclerotic heart disease with refractory angina represents the most treatment-resistant form of angina, where patients continue to experience ischemic chest pain despite maximal medical therapy.
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 I25.112. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for I25.112. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for I25.112. 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 I25.112 an HCC code?
I25.112 has no mapping under the current CMS-HCC V28 community payment model. I25.112 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
- I25.112
- Description
- Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
- 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
I25.112 is the ICD-10-CM diagnosis code for atherosclerotic heart disease of native coronary artery with refractory angina pectoris. Narrowing of heart arteries causing severe chest pain that does not respond adequately to standard angina medications. I25.112 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering ischemic heart diseases (i20-i25).
I25.112 has no mapping under the current CMS-HCC V28 community payment model. I25.112 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.
Document that the patient has failed multiple antianginal therapies before assigning this code.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I25.112 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document that the patient has failed multiple antianginal therapies before assigning this code
- •Refractory angina requires evidence of inadequate symptom control despite optimal medical management
Clinical Significance
Atherosclerotic heart disease with refractory angina represents the most treatment-resistant form of angina, where patients continue to experience ischemic chest pain despite maximal medical therapy. These patients have failed multiple antianginal medications and may not be candidates for revascularization. The refractory nature indicates severe disease burden and high resource utilization, often requiring novel therapies such as enhanced external counterpulsation or spinal cord stimulation.
Documentation Requirements
- ✓Documentation of coronary artery disease involving native vessels
- ✓Explicit documentation of 'refractory angina' or 'intractable angina'
- ✓Evidence of failure of multiple antianginal medications (nitrates, beta-blockers, calcium channel blockers, ranolazine)
- ✓Documentation that revascularization is not feasible or has been attempted
- ✓Impact on functional status and quality of life
- ✓Alternative treatment strategies being employed
Commonly Confused Codes
- •I25.110: Same condition with unstable angina: unstable but potentially treatment-responsive
- •I25.111: Same condition with documented spasm: specific spasm mechanism
- •I25.118: Same condition with other forms of angina: for other angina types
- •I25.119: Same condition with unspecified angina: less specific