I20.81 Angina pectoris with coronary microvascular dysfunction

Billable ICD-10-CM code, FY2026.

Applicable to

• Angina pectoris with coronary microvascular disease

Applies from I20 Angina pectoris

Excludes1 (never code together)

• angina pectoris with atherosclerotic heart disease of native coronary arteries (I25.1-)
• atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris (I25.7-)
• postinfarction angina (I23.7)

Use additional code

• code to identify:
• exposure to environmental tobacco smoke (Z77.22)
• history of tobacco dependence (Z87.891)
• occupational exposure to environmental tobacco smoke (Z57.31)
• tobacco dependence (F17.-)
• tobacco use (Z72.0)

Applies from I20.8 Other forms of angina pectoris

Use additional code

• code(s) for symptoms associated with angina equivalent

Risk adjustment (HCC)

• CMS-HCC V22: HCC 88 — Angina Pectoris
• RxHCC V08: HCC 188 — Coronary Artery Disease
• ESRD V24: HCC 88

MS-DRG index

Defines the logic of DRG(s) 311 in MDC 05.

Code annotations containing back-references to I20.81

Back-references to I20.8

• Type 1 Excludes: I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris ("other forms of angina pectoris without atherosclerotic heart disease (I20.8-)")
• Type 1 Excludes: I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris ("other forms of angina pectoris without atherosclerosis of coronary artery bypass graft (I20.8-)")
• Type 1 Excludes: I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris ("other forms of angina pectoris without atherosclerosis of autologous vein coronary artery bypass graft(s) (I20.8-)")
• Type 1 Excludes: I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris ("other forms of angina pectoris without atherosclerosis of autologous artery coronary artery bypass graft(s) (I20.8-)")
• Type 1 Excludes: I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris ("other forms of angina pectoris without atherosclerosis of nonautologous biological coronary artery bypass graft(s) (I20.8-)")
• Type 1 Excludes: I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris ("other forms of angina pectoris without atherosclerosis of other coronary artery bypass graft(s) (I20.8-)")

Back-references to I20

• Type 1 Excludes: I24 Other acute ischemic heart diseases ("angina pectoris (I20.-)")

Diagnosis Index entries for I20.81

• Angina (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor) › with › coronary microvascular disease
• Angina (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor) › with › coronary microvascular dysfunction
• Disease, diseased › coronary (artery) › microvascular › with › angina pectoris
• Dysfunction › coronary microvascular › with › angina pectoris

Nearby codes

• I20 Angina pectoris
• I20.0 Unstable angina
• I20.1 Angina pectoris with documented spasm
• I20.2 Refractory angina pectoris
• I20.8 Other forms of angina pectoris
• I20.81 Angina pectoris with coronary microvascular dysfunction (this code)
• I20.89 Other forms of angina pectoris
• I20.9 Angina pectoris, unspecified