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I25.5 ICD-10-CM Code: Ischemic cardiomyopathy

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes2 · 7 use-additional codes · 1 code-also instruction
Risk adjustment
RxHCC V08 category 188

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I25.5 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on I25.5 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • the presence of hypertension (I10-I1A)

Source: inherited from I20-I25

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional 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)

Source: inherited from I25

Coder workflow for I25.5

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of I25.5(2 notes)

    Coding workflow: The conditions named in this note are not included in I25.5. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareI25.1, I25.7, I5A

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying I25.5(7 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I25.5 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewI25.82, Z77.22, Z87.891, Z57.31, F17, Z72.0

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with I25.5?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewI25.82, Z77.22, Z87.891, Z57.31, F17, Z72.0

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Ischemic cardiomyopathy is a billable ICD-10-CM diagnosis code (I25.5).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 7 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name I25.5 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes2 notes: I42 — Cardiomyopathy, I74 — Arterial embolism and thrombosis (via I25.-), I82 — Other venous embolism and thrombosis (via I25.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 302 (MDC 05), DRG 303 (MDC 05).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):CIR011 — Coronary atherosclerosis and other heart disease (default); CIR005 — Myocarditis and cardiomyopathy.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Coronary atherosclerosis and other heart disease, Myocarditis and cardiomyopathy).

I24.81 — Acute coronary microvascular dysfunction, I24.89 — Other forms of acute ischemic heart disease, I24.9 — Acute ischemic heart disease, unspecified, I25.10 — Atherosclerotic heart disease of native coronary artery without angina pectoris, I25.110 — Atherosclerotic heart disease of native coronary artery with unstable angina pectoris, I25.111 — Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm, I25.112 — Atherosclerotic heart disease of native coronary artery with refractory angina pectoris, I25.118 — Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris, I25.119 — Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris, I25.2 — Old myocardial infarction, I25.6 — Silent myocardial ischemia, I25.700 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris, I25.701 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm, I25.702 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris, I25.708 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris, I25.709 — Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris, I25.710 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris, I25.711 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm, I25.712 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris, I25.718 — Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris, +79 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Cardiomyopathy”, “Ischemia, ischemic”; these codes share that main term but sit in a different category of the Tabular List.

G45.8 — Other transient cerebral ischemic attacks and related syndromes (cerebral, recurrent focal), G45.9 — Transient cerebral ischemic attack, unspecified (cerebral, transient), G71.09 — Other specified muscular dystrophies (due to, progressive muscular dystrophy), G71.11 — Myotonic muscular dystrophy (due to, myotonia atrophica), G95.11 — Acute infarction of spinal cord (embolic) (nonembolic) (spinal cord), I09.0 — Rheumatic myocarditis (rheumatic), I20.1 — Angina pectoris with documented spasm (supply, due to vasospasm), I21.A1 — Myocardial infarction type 2 (demand, with myocardial infarction), I24.89 — Other forms of acute ischemic heart disease (demand), I24.9 — Acute ischemic heart disease, unspecified (heart, subacute), I42.00 — Dilated cardiomyopathy, unspecified (dilated), I42.01 — Familial-genetic dilated cardiomyopathy (dilated, familial-genetic), I42.09 — Other dilated cardiomyopathy (dilated, specified NEC), I42.1 — Obstructive hypertrophic cardiomyopathy (hypertrophic, obstructive), I42.2 — Other hypertrophic cardiomyopathy (hypertrophic), I42.4 — Endocardial fibroelastosis (congenital), I42.5 — Other restrictive cardiomyopathy (restrictive NEC), I42.6 — Alcoholic cardiomyopathy (alcoholic), I42.7 — Cardiomyopathy due to drug and external agent (toxic NEC), I42.81 — Arrhythmogenic cardiomyopathy (arrhythmogenic), +38 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Lipid Panel, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of I25.5 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I25.5 with these 5 related codes in Claim Check

Hierarchy

Excludes2

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 17,209 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Cardiomyopathy (familial) (idiopathic), ischemic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, heart (organic), ischemic (chronic or with a stated duration of over 4 weeks), cardiomyopathy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Ischemia, ischemic, cardiomyopathy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I25.5 — Ischemic cardiomyopathy." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/i25.5-ischemic-cardiomyopathy

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Ischemic cardiomyopathy

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I25.5 in its code family, with their registry titles.

View all codes in the I25 family