I25.712
BillableAtherosclerosis of autologous vein coronary artery bypass graft(s) 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 narrowing in a vein bypass graft causing persistent chest pain that does not respond adequately to standard medications.
Coding Tips
- •Verify documentation states the angina is 'refractory' or 'intractable' despite medical therapy
- •Confirm the graft is specifically an autologous vein graft
Clinical Significance
This code identifies atherosclerotic disease in an autologous vein bypass graft with refractory angina pectoris — angina that persists despite maximal medical therapy. Refractory angina indicates severely compromised myocardial perfusion that has failed conventional pharmacological and interventional treatments. These patients often have limited revascularization options and may require advanced therapies such as spinal cord stimulation or enhanced external counterpulsation.
Documentation Requirements
- ✓History of CABG with autologous vein graft (saphenous vein) specified
- ✓Evidence of atherosclerotic disease in the vein graft
- ✓Clear documentation that angina persists despite optimized medical therapy (maximum tolerated anti-anginal medications)
- ✓Documentation of prior interventional or surgical revascularization attempts or explanation of why revascularization is not feasible
- ✓Ongoing treatment plan addressing refractory symptoms
Commonly Confused Codes
I25.710 — Autologous vein CABG atherosclerosis with unstable angina; unstable is acute, refractory is chronic and treatment-resistantI25.718 — Autologous vein CABG atherosclerosis with other forms of angina; use for angina types not elsewhere classifiedI25.711 — Autologous vein CABG atherosclerosis with documented spasm; vasospastic mechanism, not treatment failureI20.8 — Other forms of angina pectoris; does not capture graft-specific disease
Code Hierarchy
└I25Chronic ischemic heart disease└I25.7Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris└I25.71Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris└I25.712Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris
└I25.712Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris