ICD-10 Coding for History of Coronary Artery Bypass Graft (CABG)(Z95.1, I25.700)
Complete ICD-10-CM coding and documentation guide for History of Coronary Artery Bypass Graft (CABG). Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Coronary Artery Bypass Graft (CABG)
Z95.1Primary Range
Presence of aortocoronary bypass graft
This code is used to indicate the presence of a coronary artery bypass graft without active complications.
Atherosclerosis of coronary artery bypass graft(s)
This range is used when there is active coronary artery disease affecting the grafts.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z95.1 | Presence of aortocoronary bypass graft | Use when documenting a history of CABG without active coronary artery disease affecting the graft. |
|
| I25.700 | Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina | Use when there is documented atherosclerosis in the graft with unstable angina. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for history of CABG
Essential facts and insights about History of Coronary Artery Bypass Graft (CABG)
Primary ICD-10-CM Codes for history of cabg
Decision Criteria
clinical Criteria
- Patient has a history of CABG with no current symptoms or complications.
Applicable To
- History of CABG without active complications
Excludes
- Complications of CABG (T82.2-)
Clinical Validation Requirements
- Operative report confirming CABG
- Absence of current symptoms related to graft
Code-Specific Risks
- Using Z95.1 alone when active graft disease is present
Coding Notes
- Ensure documentation specifies the absence of active graft-related disease.
I25.700 - Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina
Use when there is documented atherosclerosis in the graft with unstable angina.
Applicable To
- Active coronary artery disease affecting grafts
Excludes
- Native coronary artery disease without graft involvement
Clinical Validation Requirements
- Angiography showing graft stenosis
- Symptoms of unstable angina
Coding Notes
Ensure documentation specifies the involvement of the graft in the disease process.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.10Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.110Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Coronary Artery Bypass Graft (CABG) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z95.1.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Potential for audit issues., Financial: Risk of claim denials.
Mitigation Strategy
Use specific terms like 'graft stenosis' or 'native vessel disease'., Ensure operative reports are available.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Use I25.7- for active disease and Z95.1 as a secondary code.
Impact
Failure to specify vessel involvement can lead to coding errors.
Mitigation Strategy
Implement a checklist for documentation review.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for History of Coronary Artery Bypass Graft (CABG), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Coronary Artery Bypass Graft (CABG)
Use these documentation templates to ensure complete and accurate documentation for History of Coronary Artery Bypass Graft (CABG). These templates include all required elements for proper coding and billing.
Asymptomatic history of CABG
Specialty: Primary CareRequired Elements
- Year of CABG
- Current symptom status
- Graft patency
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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