I25.711
BillableAtherosclerosis of autologous vein coronary artery bypass graft(s) 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 buildup in a vein bypass graft causing chest pain triggered by documented coronary artery spasms.
Coding Tips
- •Confirm graft type is autologous vein and spasm is explicitly documented in the clinical record
- •This code indicates vasospastic angina in the context of a vein graft
Clinical Significance
This code captures atherosclerosis of an autologous vein coronary artery bypass graft complicated by vasospastic (Prinzmetal) angina. The combination of structural graft disease and vasospasm represents a dual-pathology mechanism for ischemia. This distinction is clinically important because vasospastic angina responds to calcium channel blockers and nitrates rather than the typical interventional approaches used for fixed obstructive disease.
Documentation Requirements
- ✓History of CABG with identified autologous vein graft (saphenous vein)
- ✓Evidence of atherosclerotic disease within the vein graft
- ✓Documented coronary artery spasm — may be confirmed by provocative testing, angiographic findings, or characteristic clinical presentation
- ✓Pattern of angina consistent with vasospasm: rest angina, cyclic or nocturnal episodes, transient ST elevation
- ✓Current medication management including calcium channel blockers or long-acting nitrates
Excludes 1 — Do NOT code together
- angina pectoris with documented spasm without atherosclerosis of autologous vein coronary artery bypass graft(s) (I20.1)
Commonly Confused Codes
I25.710 — Atherosclerosis of autologous vein CABG with unstable angina; unstable angina is hemodynamically driven, not spasmI25.718 — Atherosclerosis of autologous vein CABG with other forms of angina; for angina types not classified elsewhereI20.1 — Angina pectoris with documented spasm (Prinzmetal); captures spasm without graft atherosclerosisI25.119 — Native coronary artery atherosclerosis with unspecified angina; native vessel, not graft
Code Hierarchy
└I25Chronic ischemic heart disease└I25.7Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris└I25.71Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris└I25.711Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
└I25.711Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm