I20.2

Refractory angina pectoris

FY2027Chapter 9: Diseases of the circulatory system/I20–I25 Ischemic heart diseases

BillableComplete code, valid to report

I20.2 (also written I202) is a billable ICD-10-CM diagnosis code for refractory angina pectoris. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 6 codes in category I20 (Angina pectoris). The Alphabetic Index lists it under 1 entry. Its coding notes include a Use additional code instruction, a Code also instruction, 3 Excludes1 entries and 10 Excludes2 entries.

Use additional code

Add the listed code as a secondary code, if known.

Inherited from I20 Angina pectoris
  • code to identify:
    • 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)

Code also

Two codes may be needed to describe the condition. This note gives no sequencing order.

Also from chapter/block level (1 note)
Inherited from I20–I25 Ischemic heart diseases
  • the presence of hypertension (I10-I1A)

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from I20 Angina pectoris
  • angina pectoris with atherosclerotic heart disease of native coronary arteries (I25.1-)
  • atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris (I25.7-)
  • postinfarction angina (I23.7)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (10 notes)
Inherited from Chapter 9 Diseases of the circulatory system
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Cardiac and Circulatory clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital CC

Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 81 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 1 entry