Is I25.1 a billable ICD-10-CM code?

No. I25.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does I25.1 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Ischemic heart diseases (I20-I25).

I25.1

I25.1 — Atherosclerotic heart disease of native coronary artery

Non-billable headerICD-10-CM

I25.1 is a non-billable header ICD-10-CM code for atherosclerotic heart disease of native coronary artery. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

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

Use additional code

Add a secondary code to capture the detail described below.

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

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

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

Other codes that can never be billed with I25.1

These codes carry an Excludes1 note pointing at I25.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I25.1 alone.

I20Angina pectoris
I24.0Acute coronary thrombosis not resulting in myocardial infarction

Risk adjustment

I25.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead I25.1

2 child codes. Green means billable.

Related codes at this level

Codes that share I25. If I25.1 is not quite right, the correct code is usually one of these.

Questions about I25.1

Is I25.1 a billable ICD-10-CM code?: No. I25.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does I25.1 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Ischemic heart diseases (I20-I25).