I25.750
BillableAtherosclerosis of native coronary artery of transplanted heart with unstable angina
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
Plaque buildup in the native heart arteries of a transplanted heart, causing unstable chest pain.
Coding Tips
- •Confirm the patient has had a heart transplant and the atherosclerosis is in the native coronary arteries, not grafts
- •Document that this is post-transplant coronary artery disease
Clinical Significance
This code captures atherosclerosis developing in native coronary arteries of a transplanted heart with unstable angina. Cardiac allograft vasculopathy is a major cause of late graft failure and mortality in heart transplant recipients. Unstable angina in this population is particularly concerning because transplant recipients may have atypical ischemic presentations due to cardiac denervation, making prompt recognition critical.
Documentation Requirements
- ✓Confirmed history of heart transplantation
- ✓Evidence of atherosclerotic disease in the native coronary arteries of the transplanted heart (annual angiography or intravascular ultrasound)
- ✓Documentation of unstable angina or angina equivalent in the transplant recipient
- ✓Recognition that denervated hearts may present with atypical symptoms — dyspnea, heart failure symptoms, or silent ischemia
- ✓Immunosuppression regimen and any modifications related to vasculopathy
Commonly Confused Codes
I25.760 — Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina; involves a bypass graft in the transplanted heartI25.710 — Autologous vein CABG with unstable angina; native heart bypass graft, not transplanted heartI25.751 — Native coronary artery of transplanted heart with documented spasm; spasm rather than unstable patternT86.21 — Heart transplant failure; general transplant failure without specificity to coronary disease
Code Hierarchy
└I25Chronic ischemic heart disease└I25.7Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris└I25.75Atherosclerosis of native coronary artery of transplanted heart with angina pectoris└I25.750Atherosclerosis of native coronary artery of transplanted heart with unstable angina
└I25.750Atherosclerosis of native coronary artery of transplanted heart with unstable angina