Atherosclerosis of CABG w angina pectoris w documented spasm

This code identifies a patient experiencing chest pain due to documented coronary artery spasm, specifically when the spasm occurs in a coronary artery bypass graft (CABG) that is also affected by atherosclerosis. It signifies a dual pathology: both structural narrowing of the graft due to plaque buildup and functional constriction due to spasm.

Apply this code when documentation clearly indicates angina pectoris with a confirmed coronary artery spasm occurring within an atherosclerotic bypass graft. This typically requires diagnostic evidence such as angiography showing both graft atherosclerosis and a positive provocation test for spasm, or clinical notes explicitly stating both conditions are present in the graft.

• Ensure documentation specifies the angina is due to spasm and that the spasm is occurring in an atherosclerotic bypass graft.
• Do not use this code if the spasm is not in a bypass graft or if there is no documented atherosclerosis of the graft; consider I20.1 in such cases.
• Sequence this code as a primary diagnosis when it is the reason for the encounter, or as a secondary diagnosis if another condition is the primary reason for the visit.