I20-I25 — Ischemic heart diseases
ICD-10-CM codes I20-I25 cover ischemic heart diseases, within diseases of the circulatory system. The block holds 119 codes across 6 categories, of which 94 are billable and 25 are header codes that cannot be submitted on a claim.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- the presence of hypertension (I10-I1A)
Risk adjustment in I20-I25
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 229 Unstable Angina and Other Acute Ischemic Heart Disease
- HCC 228 Acute Myocardial Infarction
What else to watch in I20-I25
- 4 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 95 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in I20-I25
- I20Angina pectoris
- I21Acute myocardial infarction
- I22Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
- I23Certain current complications following ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (within the 28 day period)
- I24Other acute ischemic heart diseases
- I25Chronic ischemic heart disease