I25.85 ICD-10-CM Code: Chronic coronary microvascular dysfunction
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 2 inclusion terms · 1 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.
- MS-DRG 302 — ATHEROSCLEROSIS WITH MCC (MDC 05)
- MS-DRG 303 — ATHEROSCLEROSIS WITHOUT MCC (MDC 05)
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 I25.85 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 I25.85 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Chronic (presentation of) coronary microvascular disease
- Coronary microvascular dysfunction NOS
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- non-ischemic myocardial injury (I5A) Compare I25.85 vs I5A →
Source: inherited from I25
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 I25.85
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).
- Acuity
- Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
- 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 I25.85(1 note)
Coding workflow: The conditions named in this note are not included in I25.85. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareI5A
See the official tabular notes · Guidelines I.A.12.b
Use Additional Code — after identifying I25.85(7 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I25.85 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 I25.85?
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).
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
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 (4)
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.
- 7 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
- 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
- 1 Excludes2 entry — 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 I25.85 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 2 Excludes2 notes: 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).
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 category (Coronary atherosclerosis and other heart disease).
I25.761 — Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm, I25.762 — Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris, I25.768 — Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris, I25.769 — Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris, I25.790 — Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris, I25.791 — Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm, I25.792 — Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris, I25.798 — Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris, I25.799 — Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris, I25.810 — Atherosclerosis of coronary artery bypass graft(s) without angina pectoris, I25.811 — Atherosclerosis of native coronary artery of transplanted heart without angina pectoris, I25.812 — Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris, I25.82 — Chronic total occlusion of coronary artery, I25.83 — Coronary atherosclerosis due to lipid rich plaque, I25.84 — Coronary atherosclerosis due to calcified coronary lesion, I25.89 — Other forms of chronic ischemic heart disease, I25.9 — Chronic ischemic heart disease, unspecified, Z95.1 — Presence of aortocoronary bypass graft, Z95.5 — Presence of coronary angioplasty implant and graft, Z98.61 — Coronary angioplasty status, +47 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Dysfunction”; these codes share that main term but sit in a different category of the Tabular List.
H02.883 — Meibomian gland dysfunction of right eye, unspecified eyelid (meibomian gland, of eyelid, right), H02.884 — Meibomian gland dysfunction left upper eyelid (meibomian gland, of eyelid, left, upper), H02.885 — Meibomian gland dysfunction left lower eyelid (meibomian gland, of eyelid, left, lower), H02.886 — Meibomian gland dysfunction of left eye, unspecified eyelid (meibomian gland, of eyelid, left), H02.889 — Meibomian gland dysfunction of unspecified eye, unspecified eyelid (meibomian gland, of eyelid), H02.88A — Meibomian gland dysfunction right eye, upper and lower eyelids (meibomian gland, of eyelid, right, upper and lower eyelids), H02.88B — Meibomian gland dysfunction left eye, upper and lower eyelids (meibomian gland, of eyelid, left, upper and lower eyelids), I20.81 — Angina pectoris with coronary microvascular dysfunction (coronary microvascular, with, angina pectoris), I21.B — Myocardial infarction with coronary microvascular dysfunction (coronary microvascular, with, myocardial infarction), I24.81 — Acute coronary microvascular dysfunction (coronary microvascular, acute), I27.841 — Fontan-associated lymphatic dysfunction (lymphatic, Fontan-associated), I49.5 — Sick sinus syndrome (sinoatrial node), I50.9 — Heart failure, unspecified (ventricular, with congestive heart failure), I51.81 — Takotsubo syndrome (left ventricular, following sudden emotional stress), I51.89 — Other ill-defined heart diseases (heart), I51.9 — Heart disease, unspecified (ventricular), J4A.0 — Restrictive allograft syndrome (chronic, lung allograft, mixed), J4A.8 — Other chronic lung allograft dysfunction (chronic, lung allograft, specified NEC), J4A.9 — Chronic lung allograft dysfunction, unspecified (chronic, lung allograft), K31.89 — Other diseases of stomach and duodenum (stomach), +115 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.
HbA1c Test (Glycated Hemoglobin), Blood Glucose Test, Lipid Panel, Prothrombin Time Test and INR (PT/INR)
Contextual Map
Every relationship of I25.85 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 I25.85 with these 2 related codes in Claim Check
Hierarchy
- I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I20-I25 — Ischemic heart diseases[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes2 notes
- I74 — Arterial embolism and thrombosis[Excludes2](via I25.-): “coronary embolism and thrombosis (I21-I25)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I82 — Other venous embolism and thrombosis[Excludes2](via I25.-): “coronary (I21-I25)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- CIR011 — Coronary atherosclerosis and other heart disease[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 302 — ATHEROSCLEROSIS WITH MCC[MS-DRG]: “ATHEROSCLEROSIS WITH MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 303 — ATHEROSCLEROSIS WITHOUT MCC[MS-DRG]: “ATHEROSCLEROSIS WITHOUT MCC (MDC 05)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
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
- Disease, diseased, coronary (artery), microvascular, chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Dysfunction, chronic, coronary microvascular[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Dysfunction, coronary microvascular[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Dysfunction, coronary microvascular, chronic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (40)
- I25 — Chronic ischemic heart disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.72 — Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.720 — Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.721 — Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.722 — Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.728 — Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.729 — Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- I25.73 — Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2024 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2024
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. "I25.85 — Chronic coronary microvascular dysfunction." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/i25.85-chronic-coronary-microvascular-dysfunction
Change history
- FY2024 — October 1, 2023Added to the code setChronic coronary microvascular dysfunctionFY2024 changes
Nearest Codes in This Family
Official ICD-10-CM classifications closest to I25.85 in its code family, with their registry titles.
- I25.799 — Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
- I25.8 — Other forms of chronic ischemic heart disease
- I25.81 — Atherosclerosis of other coronary vessels without angina pectoris
- I25.810 — Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
- I25.811 — Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
- I25.812 — Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
- I25.82 — Chronic total occlusion of coronary artery
- I25.83 — Coronary atherosclerosis due to lipid rich plaque
- I25.84 — Coronary atherosclerosis due to calcified coronary lesion
- I25.89 — Other forms of chronic ischemic heart disease