I25.112 Atherosclerotic heart disease of native coronary artery with refractory angina pectoris

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from I25 Chronic ischemic heart disease

Excludes2 (not included here)

• non-ischemic myocardial injury (I5A)

Use additional code

• code to identify:
• chronic total occlusion of coronary artery (I25.82)
• 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 I25.1 Atherosclerotic heart disease of native coronary artery

Applicable to

• Atherosclerotic cardiovascular disease
• Coronary (artery) atheroma
• Coronary (artery) atherosclerosis
• Coronary (artery) disease
• Coronary (artery) sclerosis

Excludes2 (not included here)

• atheroembolism (I75.-)
• atherosclerosis of coronary artery bypass graft(s) and transplanted heart (I25.7-)

Use additional code

• code, if applicable, to identify:
• coronary atherosclerosis due to calcified coronary lesion (I25.84)
• coronary atherosclerosis due to lipid rich plaque (I25.83)

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) 302-303 in MDC 05.

Medicare Code Edits (MCE v43.1 (April 2026))

• Adult diagnoses (age 15 through 124): Age conflict edit. These diagnoses are clinically expected only in patients age 15 through 124.

Code annotations containing back-references to I25.112

Back-references to I25.1

• Type 1 Excludes: I20 Angina pectoris ("angina pectoris with atherosclerotic heart disease of native coronary arteries (I25.1-)")
• Type 1 Excludes: I24.0 Acute coronary thrombosis not resulting in myocardial infarction ("atherosclerotic heart disease (I25.1-)")
• Type 2 Excludes: I25.5 Ischemic cardiomyopathy ("coronary atherosclerosis (I25.1-, I25.7-)")
• Code First: I25.82 Chronic total occlusion of coronary artery ("coronary atherosclerosis (I25.1-, I25.7-, I25.81-)")
• Code First: I25.83 Coronary atherosclerosis due to lipid rich plaque ("coronary atherosclerosis (I25.1-, I25.7-, I25.81-)")
• Code First: I25.84 Coronary atherosclerosis due to calcified coronary lesion ("coronary atherosclerosis (I25.1-, I25.7-, I25.81-)")
• Type 2 Excludes: I70 Atherosclerosis ("arteriosclerotic cardiovascular disease (I25.1-)")
• Type 2 Excludes: I70 Atherosclerosis ("arteriosclerotic heart disease (I25.1-)")
• Type 2 Excludes: I70 Atherosclerosis ("coronary atherosclerosis (I25.1-)")

Back-references to I25

• Type 2 Excludes: I74 Arterial embolism and thrombosis ("coronary embolism and thrombosis (I21-I25)")
• Type 2 Excludes: I82 Other venous embolism and thrombosis ("coronary (I21-I25)")

Diagnosis Index entries for I25.112

• Arteriosclerosis, arteriosclerotic (diffuse) (obliterans) (of) (senile) (with calcification) › coronary (artery) › native vessel › with › angina pectoris › refractory

Nearby codes

• I25.1 Atherosclerotic heart disease of native coronary artery
• I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
• I25.11 Atherosclerotic heart disease of native coronary artery with angina pectoris
• I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
• I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
• I25.112 Atherosclerotic heart disease of native coronary artery with refractory angina pectoris (this code)
• I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
• I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
• I25.2 Old myocardial infarction
• I25.3 Aneurysm of heart
• I25.4 Coronary artery aneurysm and dissection