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I25.1 vs I25.5

I25.1 (Atherosclerotic heart disease of native coronary artery) compared with I25.5 (Ischemic cardiomyopathy), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. I25.5 carries an Excludes2 note covering I25.1: “coronary atherosclerosis (I25.1-, I25.7-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

I25.1Atherosclerotic heart disease of native coronary arteryI25.5Ischemic cardiomyopathy
Billing statusNon-billable header

Report instead: I25.10, I25.110, I25.111, I25.112, I25.118

Billable
ClassificationI00-I99 — Diseases of the Circulatory System (I00-I99)I00-I99 — Diseases of the Circulatory System (I00-I99)
DefinitionAtherosclerotic heart disease of native coronary artery is a non-billable ICD-10-CM category code (I25.1).Ischemic cardiomyopathy is a billable ICD-10-CM diagnosis code (I25.5).
Includes
Atherosclerotic cardiovascular disease
Coronary (artery) atheroma
Coronary (artery) atherosclerosis
Coronary (artery) disease
Use additional code
code, if applicable, to identify:
coronary atherosclerosis due to calcified coronary lesion (I25.84)
coronary atherosclerosis due to lipid rich plaque (I25.83)
code to identify:
chronic total occlusion of coronary artery (I25.82)
exposure to environmental tobacco smoke (Z77.22)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources