ICD-10 Code for Coronary Artery Disease (CAD) – Complete Guide & Billing Information

Coronary Artery Disease (CAD) is a leading cause of heart-related illnesses worldwide, affecting millions annually. Accurate medical documentation and proper use of the ICD-10 code for coronary artery disease are crucial for diagnosis, treatment, and billing. Errors in coding can lead to claim denials, delayed reimbursements, and gaps in patient care.

For healthcare providers, coders, and billing professionals, understanding CAD-specific ICD-10 codes, like I25.10 – Atherosclerotic heart disease of the native coronary artery without angina pectoris, is essential. These codes ensure accurate billing, streamline workflows, and improve patient outcomes.

This guide explores key ICD-10 codes for CAD, helping you navigate documentation with confidence and precision.

What is Coronary Artery Disease (CAD)?

Coronary Artery Disease (CAD) is a chronic condition where plaque builds up in the coronary arteries, narrowing them and restricting blood flow to the heart. This condition can lead to angina (chest pain), heart attacks, and heart failure if left untreated. CAD is the most common form of heart disease and a leading cause of death worldwide.

Accurate ICD-10 coding for CAD is essential for:
✔ Proper medical documentation
✔ Correct insurance reimbursement
✔ Efficient healthcare management

Primary ICD-10 Code for Coronary Artery Disease

I25.10 – Atherosclerotic Heart Disease of Native Coronary Artery Without Angina Pectoris. The most commonly used ICD-10 code for CAD is I25.10, which applies when a patient has atherosclerotic heart disease but does not experience angina (chest pain).

Clinical Notes for I25.10:

• Used when atherosclerosis is diagnosed without any anginal symptoms.
• Often found in patients with a history of cardiovascular disease or risk factors like high cholesterol, smoking, or diabetes.

List of ICD-10 Codes for Coronary Artery Disease (CAD)

Exclusions and Additional Codes:

• Excludes2: Non-ischemic myocardial injury (I5A)
• Use additional codes for:
  • Chronic total occlusion of coronary artery (I25.82)
  • History of tobacco dependence (Z87.891)
  • Exposure to environmental tobacco smoke (Z77.22)

Billable ICD-10 Codes for Coronary Artery Disease

Many ICD-10 CAD codes are billable, meaning they are recognized for insurance reimbursement when correctly documented.

Billable CAD ICD-10 Codes:

Billable codes ensure proper insurance reimbursement, making accurate clinical documentation critical for healthcare providers.

Best Practices for ICD-10 Coding of CAD

Key Documentation Considerations:

• Specify if angina is present and its type (stable, unstable, silent ischemia).
• Indicate whether CAD is in a native artery or bypass graft.
• Document any prior interventions like stents or bypass surgery.
• Include relevant risk factors such as smoking history, hypertension, and diabetes.

Common ICD-10 Coding Mistakes to Avoid:

• Using unspecified codes when more specific ones are available.
• Not documenting unstable angina when present.
• Failing to note bypass graft involvement leads to incorrect coding.

Summary

Accurate ICD-10 coding for Coronary Artery Disease (CAD) is essential for effective patient care, proper reimbursement, and streamlined healthcare operations. Using the correct ICD-10 codes, such as I25.10 for CAD without angina and I25.110 for CAD with unstable angina, ensures proper documentation and prevents claim denials.

By following best practices, avoiding common coding mistakes, and keeping up with the latest ICD-10 updates, healthcare providers can enhance patient care and maintain compliance with medical billing regulations.

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