ICD-10 I25.759
Billable / Specific HCC v28: 88 CCAtherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
About ICD-10-CM I25.759
ICD-10-CM code I25.759 represents Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris. This is a billable/specific code in the Circulatory System chapter (block I25). The 2026 edition of ICD-10-CM I25.759 became effective on October 1, 2025.
Coding Tips for I25.759
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I25.759 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.
I25.759 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 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I25.759
Local Coverage Determinations (LCDs) from CMS MACs that list I25.759 as a covered diagnosis.
Showing top 10 of 450 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I25.759.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with I25.759
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 75574 CMS LCD: Billing and Coding: Coronary Computed Tomography Angiography (CCTA) CMS LCD
- 75573 CMS LCD: Billing and Coding: Coronary Computed Tomography Angiography (CCTA) CMS LCD
- 75572 CMS LCD: Billing and Coding: Coronary Computed Tomography Angiography (CCTA) CMS LCD
- 75571 CMS LCD: Billing and Coding: Coronary Computed Tomography Angiography (CCTA) CMS LCD
Convert I25.759 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 |
|---|---|---|
| I25.759 | 4139 | 10112 |
| I25.759 | 41406 | 10111 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I25.759
Other codes in section I20-I25 (Ischemic heart diseases).
ICD-10 I25.759, Billing FAQ
Is ICD-10 code I25.759 billable? +
Yes, I25.759 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I25.759 affect Medicare Advantage HCC risk adjustment? +
Yes. I25.759 maps to CMS-HCC v28 category 88. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I25.759 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 I25.759? +
Procedures frequently paired with I25.759 include: 75574, 75573, 75572, 75571.
What ICD-9 codes does I25.759 map to? +
Per CMS GEMs, I25.759 maps to ICD-9 codes: 4139, 41406. 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 May 31, 2026.
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