I25.701
BillableAtherosclerosis of coronary artery bypass graft(s), unspecified, 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
Plaque narrowing in coronary artery bypass grafts causing chest pain triggered by coronary artery spasms that have been documented.
Coding Tips
- •Ensure documentation explicitly mentions 'vasospastic angina' or 'coronary spasm' to support this code
- •This represents Prinzmetal's angina variant; verify spasm is documented in clinical notes
Clinical Significance
This code captures atherosclerosis of coronary artery bypass grafts with vasospastic angina, a condition where graft disease coexists with coronary spasm causing chest pain. Vasospastic angina in bypass graft patients may involve spasm of either the graft itself or native vessels. The documentation of spasm is important because it changes the treatment approach, typically requiring calcium channel blockers rather than beta-blockers.
Documentation Requirements
- ✓Documentation of atherosclerosis in coronary artery bypass graft(s)
- ✓History of prior coronary artery bypass graft surgery
- ✓Documented coronary spasm (vasospastic or Prinzmetal's angina)
- ✓Objective evidence of spasm (electrocardiogram changes, angiographic demonstration)
- ✓Bypass graft type if known
- ✓Treatment plan addressing the vasospastic component
Excludes 1 — Do NOT code together
- angina pectoris with documented spasm without atherosclerosis of coronary artery bypass graft (I20.1)
Commonly Confused Codes
I25.700 — Same condition with unstable angina: unstable angina without documented spasm, higher HCC value (87 versus 88)I25.111 — Atherosclerotic heart disease of native coronary artery with documented spasm: for native vessels, not graftsI25.702 — Same condition with refractory angina: treatment-resistant angina, different designationI20.1 — Angina pectoris with documented spasm: without documented graft disease
Code Hierarchy
└I25Chronic ischemic heart disease└I25.7Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris└I25.70Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris└I25.701Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
└I25.701Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm