I25.119 ICD-10-CM Code: Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.119 is not a CMS-HCC payment code. 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)
I25.119
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtherosclerotic heart disease of native coronary artery with unspecified angina pectoris
Narrowing of heart arteries causing chest pain, but the specific type or pattern of the chest pain is not specified in the documentation.
Buddy Insight
Atherosclerotic heart disease of native coronary artery with unspecified angina is used when coronary artery disease is confirmed and angina is present but the specific type of angina cannot be determined from documentation.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 88
RAF 0.135
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 88
RAF 0.043
RXHCC
MappedHCC 188
RAF 0.052
Code Book Path
Inclusion Terms
Official- Atherosclerotic heart disease with angina NOS
- Atherosclerotic heart disease with ischemic chest pain
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I25.119 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I25.119 in this effective period.
Excludes 1
Official- unspecified angina pectoris without atherosclerotic heart disease (I20.9)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I25.119 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I25.119 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I25.119 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 I25.119 an HCC code?
Yes. I25.119 maps to Angina Pectoris under the V24 model but is not retained in V28.
- Code
- I25.119
- Description
- Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- 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 I25.119 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I25.119
For I25.119 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 I25.119 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I25.119 is the ICD-10-CM diagnosis code for atherosclerotic heart disease of native coronary artery with unspecified angina pectoris. Narrowing of heart arteries causing chest pain, but the specific type or pattern of the chest pain is not specified in the documentation. I25.119 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 older CMS-HCC V24 model, I25.119 maps to Angina Pectoris (HCC 88) with a community, non-dual, aged base RAF weight of 0.135. 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.
Native-artery CAD with unspecified angina pectoris. The provider documents both CAD and angina but does not characterize the angina pattern (stable vs unstable vs spasm). Because I25.119 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 I25.119 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Native-artery CAD with unspecified angina pectoris. The provider documents both CAD and angina but does not characterize the angina pattern (stable vs unstable vs spasm).
- •Do not default to I25.119 when documentation supports a specific angina type. Only I25.110 (unstable angina) maps to a V28 HCC (229); I25.111 (with spasm) and I25.118 (other) carry no V28 coefficient, so specificity here is about audit defensibility and accuracy, not RAF. Query the provider when the chart includes a pattern descriptor.
- •I25.119 does not map to a V28 payment HCC. The specificity gap between I25.10 (no angina) and I25.119 (with angina) is meaningful for chart completeness, but neither carries a V28 coefficient; the 119 vs 118 vs 111 distinction does not change that.
Clinical Significance
Atherosclerotic heart disease of native coronary artery with unspecified angina is used when coronary artery disease is confirmed and angina is present but the specific type of angina cannot be determined from documentation. While it captures HCC 88, it represents a documentation improvement opportunity — querying the provider for angina subtype could potentially capture unstable angina (HCC 87) if present.
Documentation Requirements
- ✓Documentation of coronary artery disease involving native vessels
- ✓Documentation that angina is present
- ✓Evidence that the specific angina type cannot be determined from available records
- ✓Clinical context supporting the anginal diagnosis
Excludes 1, Do NOT code together
- unspecified angina pectoris without atherosclerotic heart disease (I20.9)
Commonly Confused Codes
- •I25.110: Same condition with unstable angina: higher specificity and higher HCC value
- •I25.10: Same condition without angina: if angina is not documented, this code has no HCC value
- •I20.9: Angina pectoris, unspecified: for unspecified angina without documented coronary artery disease
- •I25.111-I25.118: Specific angina subtypes with coronary artery disease: preferred when the angina type is identifiable