I25.82
BillableChronic total occlusion of coronary artery
HCC Category Mapping
RxHCCHCC 188 — Coronary Artery Disease and Angina
0.000What This Code Means
A chronic condition where a coronary artery is completely blocked by plaque buildup, restricting blood flow to the heart muscle over an extended period.
Coding Tips
- •Document the specific coronary artery affected (left anterior descending, left circumflex, or right coronary artery) for more precise coding if available
- •Distinguish from acute coronary occlusion; this code specifically indicates a chronic, long-standing blockage
Clinical Significance
Chronic total occlusion of a coronary artery represents complete blockage of a coronary vessel that has been present for an extended period (typically defined as greater than 3 months). This is an additional code that should be used with a code from I25.1- to indicate the severity of the coronary artery disease. CTOs are found in approximately 20-30% of patients undergoing diagnostic catheterization and represent a significant technical challenge for revascularization.
Documentation Requirements
- ✓Angiographic confirmation of 100% occlusion of a coronary artery
- ✓Documentation that the occlusion is chronic (present >3 months) rather than acute
- ✓Identification of which coronary artery is occluded
- ✓Documentation of collateral circulation if present
- ✓Use as additional code with I25.1- codes for the underlying atherosclerotic disease
Excludes 1 — Do NOT code together
Commonly Confused Codes
I25.10-I25.19 — Atherosclerotic heart disease of native coronary artery; use as primary code with I25.82 as additionalI21.- — Acute myocardial infarction; acute occlusion, not chronicI25.810 — CABG atherosclerosis without angina; graft disease, not native vessel CTOI25.84 — Coronary atherosclerosis due to calcified lesion; calcification descriptor, not complete occlusion
Code Hierarchy
└I25Chronic ischemic heart disease└I25.8Other forms of chronic ischemic heart disease└I25.82Chronic total occlusion of coronary artery
└I25.82Chronic total occlusion of coronary artery