2027 ICD-10-CM Diagnosis Code I25.811Atherosclerosis of native coronary artery of transplanted heart without angina pectoris

ICD-10-CM Codes›I00–I99›I20-I25›I25

ICD-10-CM I25.811
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

I25.811 is a billable ICD-10-CM diagnosis code for atherosclerosis of native coronary artery of transplanted heart without 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 43 closely related codes. Coders also document this condition as accelerated coronary artery disease in transplanted heart. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Coronary atherosclerosis and other heart disease.

I25.811 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 188 for payment year 2027.

This medical diagnosis code is frequently used in Cardiology medical specialties to designate conditions such selected atherosclerosis, ischemia, and infarction.

Code Identity

ICD-10-CM Code
I25.811
Billable Status
Yes — Valid for Submission
Code Describes
Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
Short Description
Athscl native cor art of transplanted heart w/o ang pctrs
Parent Code
I25.81
Atherosclerosis of other coronary vessels without angina pectoris

Code Classification

ChapterI00–I99Diseases of the circulatory system
SectionI20-I25Ischemic heart diseases
CategoryI25Chronic ischemic heart disease
This CodeI25.811Atherosclerosis of native coronary artery of transplanted heart without angina pectoris

Medicare Risk Adjustment (HCC)Billing

I25.811 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
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.

  • Accelerated coronary artery disease in transplanted heart
  • Coronary arteriosclerosis in artery of transplanted heart

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to I25.811: its own notes plus those printed at I25.81, I25, block I20-I25, and Chapter 9. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Atherosclerosis of native coronary artery of transplanted heart NOS

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • atherosclerosis of native coronary artery of transplanted heart with angina pectoris (I25.75-)

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 I25.81 Atherosclerosis of other coronary vessels without angina pectoris applies to 3 codes
  • atherosclerotic heart disease of native coronary artery without angina pectoris (I25.10)
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 I25.81 Atherosclerosis of other coronary vessels without angina pectoris applies to 3 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 I25.811, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming I25.811: they are not reported together with it, unless the two conditions are unrelated.

  • I25.7 Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris
    atherosclerosis of native coronary artery of transplanted heart without angina pectoris (I25.811)
  • I25.75 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris
    atherosclerosis of native coronary artery of transplanted heart without angina pectoris (I25.811)
  • T86.290 Cardiac allograft vasculopathy
    atherosclerosis of coronary arteries (I25.75-, I25.76-, I25.81-) names I25.81-, which includes this code

Excludes2 2

These codes carry an Excludes2 note naming I25.811: its condition is not part of those codes, and both may be reported when the patient has both.

  • 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 I25.811 is one of the conditions named.

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

Atherosclerosis

Atherosclerosis is a condition in which plaque builds up inside your arteries. Plaque is a sticky substance made up of cholesterol, fat, blood cells, calcium, and other substances found in the blood. Over time, plaque hardens and causes your arteries to narrow. That limits the flow of oxygen-rich blood to your body.

The full article covers:

  • What is atherosclerosis?
  • What causes atherosclerosis?
  • Who is more likely to develop atherosclerosis?
  • What are the symptoms of atherosclerosis?
  • What other problems can atherosclerosis cause?
  • How is atherosclerosis diagnosed?
  • What are the treatments for atherosclerosis?
  • Can atherosclerosis be prevented?

Read the full article at MedlinePlus

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

Convert I25.811 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
414.06 Cor ath natv art tp hrt
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About I25.811Overview

Is I25.811 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report atherosclerosis of native coronary artery of transplanted heart without angina pectoris on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does I25.811 group to?

When atherosclerosis of native coronary artery of transplanted heart without 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 I25.811 a CC or MCC?

CMS lists I25.811 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 43 closely related codes in its exclusion list.

Can I25.811 be reported with a code from I25.75?

Not as a rule. The Excludes1 note on I25.811 lists "atherosclerosis of native coronary artery of transplanted heart with angina pectoris (I25.75-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does I25.811 need an additional code?

When the condition applies, yes. The Use Additional Code note at I25.81, which applies to I25.811, 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 I25.811.

Does I25.811 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: I25.811 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 188 (Coronary Artery Disease).