2027 ICD-10-CM Diagnosis Code I25.112Atherosclerotic heart disease of native coronary artery with refractory angina pectoris

ICD-10-CM Codes›I00–I99›I20-I25›I25

ICD-10-CM I25.112
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

I25.112 is a billable ICD-10-CM diagnosis code for atherosclerotic heart disease of native coronary artery with refractory angina pectoris. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 302 through 303. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 82 closely related codes. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). Coders also document this condition as refractory angina. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Coronary atherosclerosis and other heart disease.

I25.112 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 88 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 88, ESRD (V21) category 88, ESRD (V24) category 88, and RxHCC Part D (V08) category 188 for payment year 2027.

Code Identity

ICD-10-CM Code
I25.112
Billable Status
Yes — Valid for Submission
Code Describes
Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
Short Description
Athscl heart dis of native cor art with refract ang pctrs
Parent Code
I25.11
Atherosclerotic heart disease of native coronary artery with angina pectoris

Code Classification

ChapterI00–I99Diseases of the circulatory system
SectionI20-I25Ischemic heart diseases
CategoryI25Chronic ischemic heart disease
This CodeI25.112Atherosclerotic heart disease of native coronary artery with refractory angina pectoris

Code EditsBilling

Medicare Code Editor checks that affect claim validity for I25.112.

Adult diagnoses
The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Medicare Risk Adjustment (HCC)Billing

I25.112 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 88
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 88 · ESRD (V21): HCC 88 · ESRD (V24): HCC 88
ESRD V21 weights: 0.048 dialysis, 0.129–0.392 functioning graft · ESRD V24 weights: 0.043 dialysis, 0.071–0.280 functioning graft
Part D (RxHCC)
RxHCC 188 — Coronary Artery Disease
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Refractory angina
  • Refractory angina due to coronary arteriosclerosis

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to I25.112: its own notes plus those printed at I25.1, I25, block I20-I25, and Chapter 9. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From I25.1 Atherosclerotic heart disease of native coronary artery applies to 6 codes
  • atheroembolism (I75.-)
  • atherosclerosis of coronary artery bypass graft(s) and transplanted heart (I25.7-)
From I25 Chronic ischemic heart disease applies to 56 codes
  • non-ischemic myocardial injury (I5A)
From Chapter 9 (I00-I99) Diseases of the circulatory system applies to 1,433 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From I25.1 Atherosclerotic heart disease of native coronary artery applies to 6 codes
  • code, if applicable, to identify:
  • coronary atherosclerosis due to calcified coronary lesion (I25.84)
  • coronary atherosclerosis due to lipid rich plaque (I25.83)
From I25 Chronic ischemic heart disease applies to 56 codes
  • 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)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block I20-I25 Ischemic heart diseases applies to 94 codes
  • the presence of hypertension (I10-I1A)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name I25.112, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming I25.112: they are not reported together with it, unless the two conditions are unrelated.

  • I20 Angina pectoris
    angina pectoris with atherosclerotic heart disease of native coronary arteries (I25.1-) names I25.1-, which includes this code
  • I24.0 Acute coronary thrombosis not resulting in myocardial infarction
    atherosclerotic heart disease (I25.1-) names I25.1-, which includes this code

Excludes2 6

These codes carry an Excludes2 note naming I25.112: its condition is not part of those codes, and both may be reported when the patient has both.

  • I25.5 Ischemic cardiomyopathy
    coronary atherosclerosis (I25.1-, I25.7-) names I25.1-, which includes this code
  • I70 Atherosclerosis
    arteriosclerotic cardiovascular disease (I25.1-) names I25.1-, which includes this code
  • I70 Atherosclerosis
    arteriosclerotic heart disease (I25.1-) names I25.1-, which includes this code
  • I70 Atherosclerosis
    coronary atherosclerosis (I25.1-) names I25.1-, which includes this code
  • I74 Arterial embolism and thrombosis
    coronary embolism and thrombosis (I21-I25) names I21-I25, which includes this code
  • I82 Other venous embolism and thrombosis
    coronary (I21-I25) names I21-I25, which includes this code

Code First 3

These codes say to code first a condition named in the note, and I25.112 is one of the conditions named.

  • I25.82 Chronic total occlusion of coronary artery
    coronary atherosclerosis (I25.1-, I25.7-, I25.81-) names I25.1-, which includes this code
  • I25.83 Coronary atherosclerosis due to lipid rich plaque
    coronary atherosclerosis (I25.1-, I25.7-, I25.81-) names I25.1-, which includes this code
  • I25.84 Coronary atherosclerosis due to calcified coronary lesion
    coronary atherosclerosis (I25.1-, I25.7-, I25.81-) names I25.1-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR CIR011
Coronary atherosclerosis and other heart disease
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Angina

Angina is chest pain or discomfort you feel when there is not enough blood flow to your heart muscle. Your heart muscle needs the oxygen that the blood carries. Angina may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw, or back.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Code History & ChangesHistory

Replacement I25.112 replaces the following previously assigned code(s):

  • I25.110 - Athscl heart disease of native cor art w unstable ang pctrs
  • I25.111 - Athscl heart disease of native cor art w ang pctrs w spasm
  • I25.118 - Athscl heart disease of native cor art w oth ang pctrs
FY 2023AddedAdded to the ICD-10-CM code setEffective October 1, 2022.
FY 2024RevisedCode revised
FY 2025–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About I25.112Overview

Is I25.112 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report atherosclerotic heart disease of native coronary artery with refractory angina pectoris on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does I25.112 group to?

When atherosclerotic heart disease of native coronary artery with refractory angina pectoris is the principal diagnosis on an inpatient stay, it groups to MS-DRG 302, 303, with relative weights from 0.6610 to 1.1993 depending on complications. Higher weights mean higher Medicare reimbursement.

Is I25.112 a CC or MCC?

CMS lists I25.112 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 82 closely related codes in its exclusion list.

Who can I25.112 be reported for?

The Medicare Code Editor checks atherosclerotic heart disease of native coronary artery with refractory angina pectoris against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

Does I25.112 need an additional code?

When the condition applies, yes. The Use Additional Code note at I25.1, which applies to I25.112, reads: code, if applicable, to identify: coronary atherosclerosis due to calcified coronary lesion (I25.84); coronary atherosclerosis due to lipid rich plaque (I25.83). The additional code is reported after I25.112.

Does I25.112 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. I25.112 mapped to HCC 88 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 88 (Angina Pectoris), ESRD (V21) category 88 (Angina Pectoris), ESRD (V24) category 88 (Angina Pectoris), and RxHCC Part D (V08) category 188 (Coronary Artery Disease).