Refractory angina pectoris

This code signifies chronic, severe angina that is unresponsive to conventional medical therapies, including optimal pharmacologic treatment, revascularization procedures (e.g., bypass surgery, angioplasty), or both. Patients experience persistent chest pain despite maximal efforts to manage their coronary artery disease.

Apply this code when documentation explicitly states "refractory angina" or describes chronic angina that has failed to respond to standard treatments. This diagnosis is typically made after a comprehensive evaluation confirming persistent symptoms despite appropriate interventions.

• Ensure documentation clearly specifies "refractory" to differentiate from other forms of angina.
• Do not use for acute or unstable angina; those have specific codes.
• Code any underlying coronary artery disease (e.g., I25.10) as a primary or secondary diagnosis, as appropriate.