I25.761
BillableAtherosclerosis of bypass graft of coronary artery of transplanted heart 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 bypass graft of a transplanted heart causing chest pain with documented coronary artery spasm.
Coding Tips
- •Ensure documentation specifies both the transplanted heart status and documented vasospasm
- •Confirm the atherosclerosis is in the bypass graft, not the native coronary arteries
Clinical Significance
This code identifies atherosclerosis in a bypass graft of a coronary artery in a transplanted heart with vasospastic angina. The triple complexity — transplant, bypass graft, and vasospasm — makes this an extremely rare and challenging clinical scenario. Immunosuppressive medications may contribute to endothelial dysfunction and vasospasm in the graft vessels.
Documentation Requirements
- ✓Confirmed heart transplant history
- ✓History of CABG after transplantation with graft type documented
- ✓Evidence of atherosclerotic disease in the bypass graft of the transplanted heart
- ✓Documented coronary vasospasm in the graft vessel confirmed by testing or clinical presentation
- ✓Treatment plan addressing vasospasm, graft atherosclerosis, and immunosuppression management
Commonly Confused Codes
I25.751 — Native coronary artery of transplanted heart with documented spasm; native vessel, not graftI25.711 — Autologous vein CABG with documented spasm; non-transplant heartI25.760 — Bypass graft of transplanted heart with unstable angina; unstable rather than vasospasticI20.1 — Angina with documented spasm; non-specific, not transplant or graft
Code Hierarchy
└I25Chronic ischemic heart disease└I25.7Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris└I25.76Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris└I25.761Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
└I25.761Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm