ICD-10 Code for CAD: Complete Coding Guide

The ICD-10-CM code for coronary artery disease (CAD) without angina is I25.10 – Atherosclerotic heart disease of native coronary artery without angina pectoris. When CAD is documented with angina, the appropriate code depends on the type of angina. CAD involving coronary artery bypass grafts also requires more specific coding based on the graft and angina status.

Accurate CAD ICD-10 coding requires complete provider documentation and careful code selection. The diagnosis, presence and type of angina, coronary artery or bypass graft involvement, and other documented conditions can affect code assignment.

This guide explains the most commonly used ICD-10-CM codes for CAD, coding scenarios, documentation requirements, and common errors to avoid.

What Is Coronary Artery Disease (CAD)?

Coronary artery disease is a condition in which the coronary arteries become narrowed or blocked, commonly because of atherosclerotic plaque buildup. CAD may occur with or without angina and may be associated with other cardiovascular conditions.

From a coding perspective, the documented clinical details are important because ICD-10-CM provides different codes based on the presence and type of angina and whether the atherosclerosis involves native coronary arteries or coronary artery bypass grafts.

What Is the ICD-10 Code for CAD?

For coronary artery disease without angina involving a native coronary artery, the applicable ICD-10-CM code is:

I25.10 – Atherosclerotic heart disease of native coronary artery without angina pectoris

This is the primary code to consider when the provider documents CAD or atherosclerotic heart disease of the native coronary artery without angina.

CAD ICD-10 Codes 

CMS’s ICD-10-CM references distinguish these CAD codes according to angina status and other documented details.

How Is CAD Coded With Angina?

When the provider documents CAD with angina, coders should not automatically assign I25.10. A more specific combination code may apply based on the documented type of angina.

For example:

• • CAD without angina: I25.10
  • CAD with unstable angina: I25.110
  • CAD with documented coronary spasm and angina: I25.111
  • CAD with refractory angina: I25.112
  • CAD with other forms of angina: I25.118
  • CAD with unspecified angina: I25.119

The documentation should support the specific diagnosis selected.

CAD ICD-10 Coding Scenarios

Scenario 1: CAD Without Angina

Documentation:

The provider documents atherosclerotic coronary artery disease without angina.

ICD-10-CM: I25.10

Scenario 2: CAD With Unstable Angina

Documentation:

The provider documents atherosclerotic heart disease of the native coronary artery with unstable angina.

ICD-10-CM: I25.110

Scenario 3: CAD With Unspecified Angina

Documentation:

The provider documents CAD with angina but does not specify the type.

ICD-10-CM: I25.119

Scenario 4: CAD With Other Forms of Angina

Documentation:

The provider documents atherosclerotic heart disease of the native coronary artery with another specified form of angina that falls under the “other forms” category.

ICD-10-CM: I25.118

Scenario 5: CAD Involving a Bypass Graft

When CAD or atherosclerosis involves a coronary artery bypass graft, the coder must determine the type of graft and whether angina is documented. The I25.7x series contains more specific bypass-graft codes.

Key CAD ICD-10 Coding Guidelines

1. Review the Documentation for Angina

Determine whether the provider documented:

• • No angina
  • Unstable angina
  • Refractory angina
  • Angina with documented spasm
  • Other specified angina
  • Unspecified angina

The documented condition should drive code selection.

2. Determine Native Coronary Artery vs. Bypass Graft

Do not assume that every CAD diagnosis should be coded with I25.10. If the documentation indicates a coronary artery bypass graft is involved, review the appropriate I25.7x code category.

3. Use the Most Specific Supported Code

When the documentation supports a more specific code, avoid defaulting to an unspecified option.

4. Review Other Documented Conditions

CAD may coexist with other cardiovascular or chronic conditions. Review the complete documentation and applicable ICD-10-CM guidelines to determine whether additional diagnoses should be reported.

Documentation Tips for Providers

Clear documentation can help support accurate CAD coding. Providers should document relevant details such as:

• • CAD or atherosclerotic heart disease diagnosis
  • Presence or absence of angina
  • Type of angina, when applicable
  • Native coronary artery or bypass-graft involvement
  • History of CABG or other relevant cardiac procedures
  • Other clinically relevant cardiovascular conditions

Better documentation gives coders the information needed to select the most specific supported ICD-10-CM code.

Common CAD Coding Errors to Avoid

Some common issues include:

• • Using I25.10 when angina is documented
  • Selecting an unspecified angina code when the documentation supports a more specific type
  • Failing to identify bypass-graft involvement
  • Confusing a history of myocardial infarction with a current CAD diagnosis
  • Selecting a code without reviewing the full provider documentation
  • Using outdated code information without checking the applicable ICD-10-CM code set

CAD and Risk Adjustment

CAD can be relevant to risk adjustment and quality reporting, depending on the applicable program, diagnosis, documentation, and coding requirements. Accurate documentation and code assignment help ensure that reported diagnoses appropriately reflect the patient’s documented clinical conditions.

Summary: CAD ICD-10 Coding

The key points for CAD ICD-10 coding are:

• • I25.10 applies to atherosclerotic heart disease of the native coronary artery without angina pectoris.
  • CAD with angina requires selection of a more specific code based on the documented type of angina.
  • I25.118 represents CAD with other forms of angina.
  • I25.119 represents CAD with unspecified angina.
  • CAD involving coronary artery bypass grafts requires review of the appropriate I25.7x category.
  • Code selection should be based on provider documentation and the applicable ICD-10-CM guidelines.

Final Thoughts

Accurate CAD ICD-10 coding depends on more than identifying the diagnosis as coronary artery disease. Coders should review the documentation for angina status, type of angina, native coronary artery or bypass-graft involvement, and other relevant clinical details.

Because ICD-10-CM codes and guidelines are updated periodically, coding teams should verify the applicable code set for the date of service. CMS currently provides FY2026 and FY2027 ICD-10-CM files and guidelines through its ICD-10 resources

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