I25.811
BillableAtherosclerosis of native coronary artery of transplanted heart without angina pectoris
HCC Category Mapping
RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
Narrowing of the native coronary arteries in a transplanted heart without causing chest pain.
Coding Tips
- •This is specific to transplanted hearts and native vessel disease, not bypass grafts
- •Verify that atherosclerosis involves native coronary arteries, not the transplanted vessel itself
Clinical Significance
This code identifies atherosclerosis in the native coronary arteries of a transplanted heart without angina pectoris. Cardiac allograft vasculopathy is a leading cause of late transplant failure and is routinely detected through surveillance angiography. The absence of angina may be misleading in transplant recipients due to cardiac denervation — these patients may have significant ischemia without typical chest pain symptoms.
Documentation Requirements
- ✓Confirmed heart transplant history
- ✓Evidence of atherosclerotic disease in native coronary arteries of the transplanted heart (typically via surveillance catheterization or intravascular ultrasound)
- ✓Documentation that the patient is NOT experiencing angina or angina-equivalent symptoms currently
- ✓Surveillance protocol for allograft vasculopathy
- ✓Immunosuppression management and optimization plan
Excludes 1 — Do NOT code together
- atherosclerosis of native coronary artery of transplanted heart with angina pectoris (I25.75-)
Commonly Confused Codes
I25.750-I25.759 — Atherosclerosis of native coronary artery of transplanted heart WITH angina; use when angina is presentI25.812 — Atherosclerosis of bypass graft of transplanted heart without angina; graft vessel, not nativeI25.10 — Atherosclerotic heart disease of native coronary artery without angina; non-transplant patientT86.290 — Cardiac allograft vasculopathy, unspecified; alternative classification