ICD-10 I25.42
Billable / Specific MCCCoronary artery dissection
About ICD-10-CM I25.42
ICD-10-CM code I25.42 represents Coronary artery dissection. This is a billable/specific code in the Circulatory System chapter (block I25). The 2026 edition of ICD-10-CM I25.42 became effective on October 1, 2025.
Coding Tips for I25.42
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I25.42 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, MCC
codes Coronary artery dissection. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for I25.42
Local Coverage Determinations (LCDs) from CMS MACs that list I25.42 as a covered diagnosis.
Showing top 10 of 398 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I25.42.
5 Cigna
5 Medicare
CPT Codes Commonly Billed with I25.42
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 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
- 92973 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
Convert I25.42 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I25.42 | 41412 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I25.42
Other codes in section I20-I25 (Ischemic heart diseases).
ICD-10 I25.42, Billing FAQ
Is ICD-10 code I25.42 billable? +
Yes, I25.42 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is I25.42 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with I25.42? +
Procedures frequently paired with I25.42 include: 92979, C9607, C9600, 92937, 92920.
What ICD-9 codes does I25.42 map to? +
Per CMS GEMs, I25.42 maps to ICD-9 codes: 41412. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team