I70.209 ICD-10-CM Code: Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of arteries, arterioles and capillaries (I70-I79)
I70.209
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified atherosclerosis of native arteries of extremities, unspecified extremity
Hardening and narrowing of blood vessels in the arms or legs due to plaque buildup, without specific symptoms or location details.
Buddy Insight
Unspecified atherosclerosis of native arteries of the extremities indicates peripheral arterial disease without documentation of specific clinical manifestations such as claudication, rest pain, or ulceration.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
MappedHCC 108
RAF 0.288
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 108
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I70.209 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I70.209 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I70.209 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for I70.209 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I70.209 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I70.209 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I70.209 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is I70.209 an HCC code?
Yes. I70.209 maps to Vascular Disease under the V24 model but is not retained in V28.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work I70.209 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I70.209
For I70.209to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I70.209 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I70.209 is the ICD-10-CM diagnosis code for unspecified atherosclerosis of native arteries of extremities, unspecified extremity. Hardening and narrowing of blood vessels in the arms or legs due to plaque buildup, without specific symptoms or location details. I70.209 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of arteries, arterioles and capillaries (i70-i79).
Under the older CMS-HCC V24 model, I70.209 maps to Vascular Disease (HCC 108) with a community, non-dual, aged base RAF weight of 0.288. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Use this code only when the specific extremity and symptom manifestation cannot be determined from documentation. Because I70.209 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I70.209 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the specific extremity and symptom manifestation cannot be determined from documentation
- •Review clinical notes to see if more specific laterality (right, left, bilateral) or symptom information (claudication, rest pain, ulceration) is documented
Clinical Significance
Unspecified atherosclerosis of native arteries of the extremities indicates peripheral arterial disease without documentation of specific clinical manifestations such as claudication, rest pain, or ulceration. While this code captures the underlying vascular pathology, it represents the least specific classification and may understate disease severity if clinical symptoms are present but not coded. Peripheral arterial disease is a major predictor of cardiovascular morbidity and mortality and warrants aggressive risk factor modification and surveillance.
Documentation Requirements
- ✓Documentation of the specific arterial site affected by atherosclerosis
- ✓Specification that the atherosclerosis involves native (not grafted or bypassed) arteries
- ✓Documentation of the affected extremity and laterality when known
- ✓Ankle-brachial index or other vascular study results supporting the diagnosis
- ✓Query the provider regarding presence or absence of symptoms (claudication, rest pain, ulceration) to allow assignment of a more specific code
- ✓Cardiovascular risk factor documentation and treatment plan
Commonly Confused Codes
- •I70.21x: Atherosclerosis of native arteries of extremities with intermittent claudication; use when claudication symptoms are documented
- •I70.22x: Atherosclerosis of native arteries of extremities with rest pain; use when rest pain is documented, indicating more severe disease
- •I70.3x: Atherosclerosis of unspecified type of bypass graft of extremities; use when the affected vessel is a bypass graft, not a native artery
- •I73.9: Peripheral vascular disease, unspecified; a less specific code that does not specify atherosclerosis as the cause
- •I70.0: Atherosclerosis of aorta; use when the aorta is the affected vessel rather than the extremity arteries