ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I25.119

Billable / Specific HCC v28: 88

Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris

I25
Block
2
Synonyms
521
LCDs
35
Payer Policies
58
Linked CPTs

About ICD-10-CM I25.119

ICD-10-CM code I25.119 represents Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris. This is a billable/specific code in the Circulatory System chapter (block I25). The 2026 edition of ICD-10-CM I25.119 became effective on October 1, 2025.

Coding Tips for I25.119

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I25.119 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I25.119. Per CMS ICD-10-CM Tabular 2026.

  • Atherosclerotic heart disease with angina NOS
  • Atherosclerotic heart disease with ischemic chest pain

Type 1 Excludes

Pure excludes, these codes can never be coded together with I25.119. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • unspecified angina pectoris without atherosclerotic heart disease (I20.9)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 88
ESRD-HCC
Category 88
RxHCC (Part D)
Category 88

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for I25.119

Local Coverage Determinations (LCDs) from CMS MACs that list I25.119 as a covered diagnosis.

521 LCDs

Showing top 10 of 521 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93313 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93312 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93318 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93317 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8927 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8925 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93314 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT C8926 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93316 →
CMS LCD: Billing and Coding: Transesophageal Echocardiogram
Article ID: 57179, Effective: 2026-02-26 00:00:00, 421 covered, 1 non-covered
CPT 93315 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I25.119.

35 policies

1 Aetna

Positron Emission Tomography (PET) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0071

3 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542
Plasma Brain Natriuretic Peptide in the Outpatient Setting - (0028)
Policy ID: MM_0028
Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
Policy ID: ART-52992
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423
Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
Policy ID: ART-56451
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476

CPT Codes Commonly Billed with I25.119

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

58 linkages
  • 92928 PCI with stent — CAD native vessel, unstable angina, STEMI/NSTEMI all arteries, ischemic cardiomyopathy, bypass graft disease Interventional Cardiology
  • 92979 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9607 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9600 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92937 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92920 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9608 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92943 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • C9601 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
  • 92941 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD

Convert I25.119 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I25.119 4139 10112
I25.119 41401 10111

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I25.119, Billing FAQ

Is ICD-10 code I25.119 billable? +

Yes, I25.119 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I25.119? +

ICD-10 I25.119 includes: Atherosclerotic heart disease with angina NOS; Atherosclerotic heart disease with ischemic chest pain.

What codes are Type 1 Excludes for I25.119? +

Type 1 Excludes (never code together with I25.119): unspecified angina pectoris without atherosclerotic heart disease (I20.9)

Does I25.119 affect Medicare Advantage HCC risk adjustment? +

Yes. I25.119 maps to CMS-HCC v28 category 88. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with I25.119? +

Procedures frequently paired with I25.119 include: 92928, 92979, C9607, C9600, 92937.

What ICD-9 codes does I25.119 map to? +

Per CMS GEMs, I25.119 maps to ICD-9 codes: 4139, 41401. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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