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I25.10
ICD-10-CM
Non-Obstructive Coronary Artery Disease

Understanding Non-Obstructive Coronary Artery Disease NOCAD diagnosis documentation and medical coding is crucial for accurate healthcare reimbursement. This resource provides information on INOCA symptoms diagnosis treatment and management including angina microvascular dysfunction and coronary vasospasm. Learn about appropriate ICD-10 codes like I25.110 and CPT codes for cardiac catheterization nuclear stress testing and other diagnostic procedures related to NOCAD. Improve your clinical documentation for optimal reimbursement and patient care with comprehensive guidance on Non-Obstructive Coronary Artery Disease.

Also known as

Non-Obstructive CAD
Non-Obstructive Coronary Disease

Diagnosis Snapshot

Key Facts
  • Definition : Heart disease due to narrowed coronary arteries, reducing blood flow to the heart muscle, but not completely blocked.
  • Clinical Signs : Chest pain (angina), shortness of breath, fatigue, dizziness, nausea. Silent ischemia may have no symptoms.
  • Common Settings : Cardiology clinic, primary care, emergency room, cardiac catheterization lab

Related ICD-10 Code Ranges

Complete code families applicable to AAPC I25.10 Coding
I25.1-I25.9

Atherosclerotic heart disease

Coronary artery disease due to plaque buildup.

I20.0-I20.9

Angina pectoris

Chest pain due to reduced blood flow to the heart.

I25.81-I25.89

Other forms of chronic ischemic heart disease

Includes chronic stable angina and silent ischemia.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Non-Obstructive Coronary Artery Disease (NOCAD)
Stable Angina Pectoris
Microvascular Angina

Documentation Best Practices

Documentation Checklist
  • Document angina symptoms: type, frequency, duration, radiation, relieving factors
  • Record ischemia evidence: EKG changes, stress test results, cardiac imaging findings
  • Rule out obstructive CAD: angiography/CT coronary angiography showing <50% stenosis
  • Assess and document risk factors: hypertension, diabetes, smoking, hyperlipidemia, family history
  • Note medical history and physical exam findings relevant to NOCAD diagnosis

Coding and Audit Risks

Common Risks
  • Unspecified CAD

    Coding I25.9 without further specification when documentation supports a more specific non-obstructive CAD subtype leads to inaccurate risk adjustment.

  • Atherosclerosis Coding

    Incorrectly coding atherosclerosis (I25.1) as the primary diagnosis when non-obstructive CAD (I25.8x) is the principal finding impacts severity reflection.

  • Clinical Validation Gap

    Lack of clear clinical indicators for non-obstructive CAD in the documentation makes accurate code assignment (I25.8x) challenging, leading to potential audits.

Mitigation Tips

Best Practices
  • Document angina symptoms, severity, and duration for accurate ICD-10 coding (I20.x).
  • Correlate ECG, ECHO, stress test findings with symptoms for improved CDI of NOCAD.
  • Ensure pre-authorization for advanced imaging studies complies with payer guidelines.
  • Use standardized terminology for cardiac risk factors (e.g., hypertension, diabetes) in EHR.
  • Regular chart reviews for complete NOCAD documentation support accurate HCC coding.

Clinical Decision Support

Checklist
  • 1. Angina symptoms documented (ICD-10 I20.x)
  • 2. Objective evidence of ischemia (ECG, stress test)
  • 3. Rule out obstructive CAD (angiography <50% stenosis)
  • 4. Assess cardiovascular risk factors (Dx hyperlipidemia, HTN)

Reimbursement and Quality Metrics

Impact Summary
  • Non-Obstructive Coronary Artery Disease reimbursement hinges on accurate ICD-10 coding (I20.8x) and supporting documentation for optimal payer reimbursement.
  • Quality metrics for NOCAD impact hospital reporting on appropriate diagnostic testing like coronary angiography and CCTA scans.
  • NOCAD coding accuracy directly affects appropriate cost capture and impacts hospital revenue cycle management.
  • Timely diagnosis and management of NOCAD improves patient outcomes and reduces healthcare resource utilization, positively affecting value-based care metrics.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code I20.8 for unspecified NOCAD
  • Document angina symptoms clearly
  • Confirm diagnosis with imaging studies
  • Consider coding underlying risk factors
  • Check guidelines for atypical presentations

Documentation Templates

Patient presents with symptoms suggestive of non-obstructive coronary artery disease (NOCAD).  The patient reports experiencing angina, chest pain, or chest discomfort, particularly with exertion.  Associated symptoms may include shortness of breath (dyspnea), fatigue, and palpitations.  Physical examination may reveal normal cardiac auscultation.  The patient's medical history includes risk factors for coronary artery disease such as hypertension, hyperlipidemia, diabetes mellitus, smoking, family history of CAD, or obesity.  Diagnostic workup for NOCAD may include a coronary angiogram demonstrating no significant obstructive coronary artery disease (less than 50% stenosis),  cardiac stress testing showing evidence of ischemia, or cardiac MRI revealing abnormalities in myocardial perfusion.  The patient's current medications may include antianginal medications such as nitrates or beta-blockers, statins for cholesterol management, and antiplatelet therapy such as aspirin.  The treatment plan includes optimizing medical therapy for risk factor modification, focusing on lifestyle changes including diet, exercise, and smoking cessation.  Further evaluation may include assessment of microvascular angina or vasospastic angina as potential underlying mechanisms.  Patient education regarding symptom management and medication adherence was provided.  Follow-up appointment scheduled to monitor symptom control and treatment efficacy.