I25.720
BillableAtherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
HCC Category Mapping
V28HCC 229 — Unstable Angina and Other Acute Ischemic Heart Disease
0.000V24HCC 87 — Unstable Angina and Other Acute Ischemic Heart Disease
0.274ESRDHCC 87 — Unstable Angina and Other Acute Ischemic Heart Disease
0.000RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
Buildup of plaque in a vein graft used for heart bypass surgery, causing unstable chest pain that occurs unpredictably.
Coding Tips
- •Verify documentation specifies the graft type is autologous artery and that unstable angina is present
- •Ensure this code is used only when atherosclerosis of the bypass graft is documented, not just angina alone
Clinical Significance
This code captures atherosclerotic disease in an autologous artery coronary bypass graft (typically internal mammary artery) with unstable angina. Arterial grafts generally have superior long-term patency compared to vein grafts, so atherosclerosis in an arterial graft represents a particularly concerning clinical finding. Unstable angina in this context suggests acute ischemic decompensation requiring urgent evaluation and management.
Documentation Requirements
- ✓History of CABG with autologous artery graft specified (e.g., internal mammary artery, radial artery)
- ✓Clinical or angiographic evidence of atherosclerotic disease within the arterial graft
- ✓Documentation of unstable angina pattern — new onset, accelerating, or rest angina
- ✓Acute workup including cardiac biomarkers, ECG findings, and hemodynamic assessment
- ✓Urgent treatment plan including anti-ischemic therapy and revascularization consideration
Excludes 1 — Do NOT code together
- unstable angina without atherosclerosis of autologous artery coronary artery bypass graft(s) (I20.0)
Commonly Confused Codes
I25.710 — Autologous vein CABG with unstable angina; vein graft (saphenous) rather than arterial graftI25.730 — Nonautologous biological CABG with unstable angina; allograft/xenograft rather than patient's own arteryI25.721 — Autologous artery CABG with documented spasm angina; vasospastic mechanism rather than unstable patternI20.0 — Unstable angina without graft-specific atherosclerosis
Code Hierarchy
└I25Chronic ischemic heart disease└I25.7Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris└I25.72Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris└I25.720Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
└I25.720Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris