I24.9 vs I25.9
I24.9 and I25.9 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter. The distinction is acute vs chronic.
The official note, declared on I24.9
ischemic heart disease (chronic) NOS (I25.9)
I24.9
Acute ischemic heart disease, unspecified
BillableUnspecified
- Chapter 9
- Diseases of the circulatory system
- Section
- I20-I25
Indexed under
- Cyanotic heart disease
- Ischemia, ischemic › heart › acute or with a stated duration of 4 weeks or less
- Ischemia, ischemic › heart › subacute
- Syndrome › coronary › acute NEC
I25.9
Chronic ischemic heart disease, unspecified
BillableUnspecified
- Chapter 9
- Diseases of the circulatory system
- Section
- I20-I25
Use when the record says
- Ischemic heart disease (chronic) NOS
Indexed under
- Deformity › coronary artery
- Ischemia, ischemic › heart
- Ischemia, ischemic › myocardium, myocardial
- Ischemia, ischemic › supply
- Deformity › arteryNOS › coronary
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027