I70.209 Does Not Capture in V28: Which PAD Codes Still Do

You coded I70.209 last year and it paid. The live card now says not mapped. The leftover question is whether unspecified PAD still captures in V28. It does not.

Open the live I70.209, I70.221, I70.231, and I70.261 cards before you treat a V24 habit as a payment HCC. This page is the desk table for that leftover. It is not an ulcer L89/L97 walk, not an HCC 213 walk, and not a model-update story.

*Current as of August 21, 2026. V28 mapping, not-mapped status, and CNA factors come from the live code pages named below and the 2026 Final ICD-10-CM Mappings. V24 HCC 108 (CNA 0.288) is a retired payment-year fact. Payment year 2026 is 100% V28. Look the exact code up. Do not code from this recap.*

Quick answer

I70.209 is billable ICD-10-CM. It is not mapped in CMS-HCC V28. It does not map to a V28 payment category. I70.201 and I70.211 are also not mapped. Payment in this native-artery family starts at rest pain or at ulceration/gangrene.

I70.22x rest pain maps to HCC 264 because those rows are in the PY2026 V28 map file (I70.221 → 264.0). CNA 0.455 is on the live I70.221 card. Ulceration and gangrene map to HCC 263. I70.231 is also a 383 member. 263 supersedes 383. Do not stack both. The dual-map and hierarchy live on the ulcer HCC desk. This post is the .209 payment question.

What the leftover question is asking

Coders still pull I70.209 because it was a clean V24 capture. Under V24 it mapped to HCC 108 (CNA 0.288). That is a retired payment-year fact. Label it V24. Do not read it as a V28 row.

The leftover question is simple: does unspecified atherosclerosis of native arteries still pay? On the live I70.209 card, V28 is not mapped. Billable is not the same as a payment HCC.

The V28 hub is the model list. It does not walk this code. Look the encounter code up in the encoder.

Unspecified and claudication still do not pay

Do not flatten I70.2x into one vascular HCC.

I73.9 is not a V28 workaround. It is not mapped in V28. If the provider named atherosclerosis of native arteries, use the I70.2x code the record supports. That still may not pay.

These codes are not "mapped to zero." There is no V28 payment HCC on those live cards.

Where this family starts to capture

Payment starts when the record supports rest pain, ulceration, or gangrene. Not before.

263 also supersedes 264 in the V28 hierarchy. Trumping is applied in the model. You do not delete the lower ICD-10 code from the claim to "make" the hierarchy work.

Do not reach for 264 or 263 to save V24 HCC 108. Code the I70.2x the record supports. Then look that code up.

Combination-code mechanics sit on the combination-codes post. This page does not rewrite that walk.

Query without upcoding

Query only for manifestations the provider already assessed. If laterality is in the note and you still have I70.209, that is a specificity fix, not a payment upgrade. I70.201 is still not mapped.

Do not query toward a higher-severity code the record does not support. Rest pain is not claudication with a stronger word. Ulceration is not a wish. Gangrene is not a coding goal.

A problem-list row of "PAD" from last year is not enough. Mapped codes still need monitoring, evaluation, assessment, or treatment this visit. See MEAT criteria and problem lists do not validate HCCs. MEAT is the training mnemonic. The authorities are the Official Guidelines and the record from the date of service.

Common misses

1. Treating V24 HCC 108 as live. I70.209, I70.201, and I70.211 paid under V24. PY2026 is 100% V28.

2. Reading laterality as an upgrade. I70.201 is still not mapped.

3. Calling claudication HCC 264. 264 is rest pain. I70.211 is not mapped.

4. Using I73.9 as a V28 workaround. It is not mapped.

5. Leaving I70.209 when rest pain, ulceration, or gangrene is already in the note. Assign the I70.2x the record supports, then look it up.

6. Stacking 263 and 383 on I70.231. 263 supersedes 383. The hierarchy walk is on the ulcer desk.

Two-minute check

1. Name the manifestation the provider assessed today: unspecified, claudication, rest pain, ulceration, or gangrene.

2. Assign the ICD-10-CM code the record supports. Do not pick a higher-severity I70.2x to find a payment HCC.

3. Look that exact code up on HCC Buddy or in the encoder.

4. If it is mapped (264 or 263 on the live cards above), confirm MEAT.

5. If it is not mapped, leave it as the correct ICD-10-CM code. Do not swap it for I73.9. Do not invent a V28 row.

Related

Disclaimer

This article is for professional and educational use only. It is not coding, billing, legal, or medical advice. Verify every code, HCC map, and guideline section against current official CMS and ICD-10-CM guidance and your payer's policy before you assign it. Reading it creates no provider, patient, or advisory relationship.

By the HCC Buddy Coding Team. V28 / V24 mappings and CNA factors from the cited live code pages (CMS-HCC V28 PY2026 model software and ICD-10-CM mapping file). Not medical advice. Not a CMS-HCC model change beyond V28. Not an IPPS or NCD story.

Sources

I70.209, I70.201, I70.211 (V28 not mapped; V24 HCC 108 CNA 0.288)

I70.221 (V28 HCC 264 CNA 0.455)

I70.231 (V28 HCC 263 CNA 1.118; also a 383 member)

I70.261 (V28 HCC 263 CNA 1.118)

I73.9 (V28 not mapped)

HCC 263 · HCC 264

CMS 2026 Model Software / Final ICD-10-CM Mappings