I25.751

HCC Category Mapping

What This Code Means

This code describes a condition where fatty buildup (atherosclerosis) has developed in the blood vessels of a transplanted heart, causing chest pain (angina) that is triggered by vessel spasms. This is a serious complication that can occur after heart transplantation.

Coding Tips

• •This code requires documentation of three key elements: atherosclerosis of native coronary artery, transplanted heart status, and documented angina with spasm—ensure all three are clearly documented in the medical record before assigning
• •Do not use this code for atherosclerosis in non-transplanted hearts; verify transplant status and use appropriate transplant-specific codes (I25.7xx series) rather than standard coronary atherosclerosis codes

Clinical Significance

This code identifies atherosclerosis in the native coronary arteries of a transplanted heart with vasospastic angina. In heart transplant recipients, coronary vasospasm may be related to immunosuppressive medications or endothelial dysfunction from allograft vasculopathy. The denervation of transplanted hearts can alter the presentation, making diagnostic confirmation through provocative testing or angiography particularly important.

Documentation Requirements

• ✓Confirmed heart transplant history
• ✓Evidence of atherosclerotic disease in the native coronary arteries of the transplanted heart
• ✓Documented coronary vasospasm confirmed by angiography or provocative testing
• ✓Vasospastic symptom pattern even if atypical due to cardiac denervation
• ✓Treatment plan addressing both the vasospasm and the underlying atherosclerotic disease

Commonly Confused Codes