ICD-10 I25.112
Billable / Specific HCC v28: 88 CCAtherosclerotic heart disease of native coronary artery with refractory angina pectoris
About ICD-10-CM I25.112
ICD-10-CM code I25.112 represents Atherosclerotic heart disease of native coronary artery with refractory angina pectoris. This is a billable/specific code in the Circulatory System chapter (block I25). The 2026 edition of ICD-10-CM I25.112 became effective on October 1, 2025.
Coding Tips for I25.112
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I25.112 is a CMS-HCC v28 risk-adjustment code (category 88). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
I25.112 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Atherosclerotic heart disease of native coronary artery with refractory angina pectoris. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I25.112
Local Coverage Determinations (LCDs) from CMS MACs that list I25.112 as a covered diagnosis.
Showing top 10 of 532 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I25.112.
5 Medicare
CPT Codes Commonly Billed with I25.112
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 83880 CMS LCD: Billing and Coding: B-type Natriuretic Peptide (BNP) Testing CMS LCD
- 93922 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93931 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93923 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93930 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93925 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93926 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 93924 CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies CMS LCD
- 92979 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- C9607 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
Codes Adjacent To I25.112
Other codes in section I20-I25 (Ischemic heart diseases).
ICD-10 I25.112, Billing FAQ
Is ICD-10 code I25.112 billable? +
Yes, I25.112 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I25.112 affect Medicare Advantage HCC risk adjustment? +
Yes. I25.112 maps to CMS-HCC v28 category 88. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I25.112 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with I25.112? +
Procedures frequently paired with I25.112 include: 83880, 93922, 93931, 93923, 93930.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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