I70.218

Billable

Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity

HCC Category Mapping

V24HCC 108 — Vascular Disease

0.297

ESRDHCC 108 — Vascular Disease

0.000

What This Code Means

This code describes a condition where fatty buildup narrows the arteries in the legs or arms (not the heart or brain), causing pain or cramping during walking or activity that goes away with rest. It affects an extremity other than the specific ones coded separately.

Coding Tips

•Verify the specific extremity affected (right leg, left leg, right arm, left arm) as there are more specific codes available; use I70.218 only when the extremity doesn't fit other specified categories
•Ensure documentation clearly states 'intermittent claudication' (pain with activity relieved by rest) to distinguish from other atherosclerotic presentations; this is a key clinical finding that justifies this specific 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

Code Hierarchy

└I70Atherosclerosis └I70.2Atherosclerosis of native arteries of the extremities └I70.21Atherosclerosis of native arteries of extremities with intermittent claudication └I70.218Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity

└I70.218Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity