I70.213 ICD-10-CM Code: Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of arteries, arterioles and capillaries (I70-I79)
I70.213
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
Hardening of blood vessels in both legs causing pain or cramping during walking that goes away with rest.
Buddy Insight
Atherosclerosis of native arteries of the extremities with intermittent claudication indicates peripheral arterial disease severe enough to cause exertional leg pain due to inadequate blood supply during ambulation.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
MappedHCC 108
RAF 0.297
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 108
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I70.213 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I70.213 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I70.213 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for I70.213 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I70.213 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I70.213 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I70.213 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 I70.213 an HCC code?
Yes. I70.213 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 I70.213 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I70.213
For I70.213to 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 I70.213 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
I70.213 is the ICD-10-CM diagnosis code for atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs. Hardening of blood vessels in both legs causing pain or cramping during walking that goes away with rest. I70.213 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, I70.213 maps to Vascular Disease (HCC 108) with a community, non-dual, aged base RAF weight of 0.297. 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.
This code requires documentation of claudication symptoms affecting both the right and left legs. Because I70.213 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 I70.213 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code requires documentation of claudication symptoms affecting both the right and left legs
- •Ensure bilateral involvement is explicitly stated in the clinical documentation before assigning this code
Clinical Significance
Atherosclerosis of native arteries of the extremities with intermittent claudication indicates peripheral arterial disease severe enough to cause exertional leg pain due to inadequate blood supply during ambulation. Intermittent claudication significantly impairs functional capacity and quality of life and serves as a clinical marker for systemic atherosclerotic burden with increased risk of myocardial infarction and stroke. Proper documentation of the claudication component is essential as it specifies the clinical severity stage of peripheral arterial disease.
Documentation Requirements
- ✓Documentation of the specific arterial site affected by atherosclerosis
- ✓Documentation that the patient experiences exertional leg pain that is relieved by rest (intermittent claudication)
- ✓Specification that the atherosclerosis involves native (not grafted or bypassed) arteries
- ✓Affected leg laterality must be documented (right, left, bilateral)
- ✓Ankle-brachial index or other objective vascular testing results
- ✓Walking distance or functional limitation details
- ✓Treatment plan including exercise therapy, pharmacotherapy, and consideration for revascularization
Commonly Confused Codes
- •I70.20x: Unspecified atherosclerosis of native arteries of extremities; use when no symptoms such as claudication or rest pain are documented
- •I70.22x: Atherosclerosis of native arteries of extremities with rest pain; use when pain occurs at rest, indicating more severe critical limb ischemia
- •I70.31x: Atherosclerosis of unspecified type of bypass graft of extremities with intermittent claudication; use when the affected vessel is a bypass graft
- •I73.9: Peripheral vascular disease, unspecified; a less specific alternative that should be avoided when atherosclerosis with claudication is documented
- •M79.604-M79.606: Pain in leg; use for non-vascular leg pain; do not confuse vascular claudication with musculoskeletal pain