I25.702
BillableAtherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris
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
Severe plaque buildup in coronary artery bypass grafts causing persistent chest pain that does not respond adequately to standard angina medications.
Coding Tips
- •Document must indicate the angina is 'refractory' or 'intractable' and resistant to treatment
- •Verify that multiple medications have been tried before coding refractory angina
Clinical Significance
This code captures atherosclerosis of coronary artery bypass grafts with refractory angina, indicating that the patient's graft disease is causing chest pain that does not respond to maximal medical therapy. These patients represent a particularly challenging clinical population, having already undergone surgical revascularization and now experiencing treatment-resistant symptoms, suggesting severe and diffuse coronary disease.
Documentation Requirements
- ✓Documentation of atherosclerosis in coronary artery bypass graft(s)
- ✓History of prior coronary artery bypass graft surgery
- ✓Explicit documentation of refractory or intractable angina
- ✓Evidence of failed multiple antianginal medications
- ✓Documentation that further revascularization is not feasible or has been attempted
- ✓Bypass graft type if known
- ✓Alternative treatment strategies employed
Commonly Confused Codes
I25.700 — Same condition with unstable angina: unstable but potentially treatment-responsiveI25.112 — Atherosclerotic heart disease of native coronary artery with refractory angina: for native vessels, not graftsI25.708 — Same condition with other forms of angina: for other angina typesI25.709 — Same condition with unspecified angina: less specific
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└I25.702Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris
└I25.702Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris