What is ICD-10 code I70.229?

I70.229 is the ICD-10-CM diagnosis code for Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I70.229 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I70.229 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I70.229 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I70.229 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does I70.229 map to under V28?

I70.229 maps to CMS-HCC V28 264 (Vascular Disease with Complications). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does I70.229 pay in RAF?

I70.229 carries a community, non-dual, aged (CNA) RAF weight of 0.455 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for I70.229?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For I70.229, V28 maps to Vascular Disease with Complications at RAF 0.455 while V24 mapped to Vascular Disease at RAF 0.288. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports I70.229?

Verify documentation specifies rest pain (claudication at rest) rather than exertional pain, as this indicates more severe disease and affects code selection If the affected extremity is documented (right leg, left arm, etc.), use a more specific code (I70.221, I70.222, I70.223, or I70.224) rather than the unspecified code 229 Because I70.229 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM I70.229: Atherosclerosis of native

I70.229 maps to CMS-HCC V28 264 (RAF 0.455). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

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Code lookupI70.229Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of arteries, arterioles and capillaries (I70-I79)

I70.229

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity

This code describes a condition where fatty deposits build up in the arteries of the arms or legs, causing pain even when the person is resting. The specific limb affected is not documented or specified in the medical record.

Buddy Insight

Atherosclerosis of native arteries with rest pain indicates critical limb ischemia (Fontaine Stage III/Rutherford Category 4), where blood flow is insufficient even at rest.

CMS-HCC V28

Mapped

HCC 264

Vascular Disease with Complic...

RAF 0.455

CMS-HCC V24

Mapped

HCC 108

Vascular Disease

RAF 0.288

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 108

Vascular Disease

RAF 0.073

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I70.2Atherosclerosis of native arteries of the extremities

I70.22Atherosclerosis of native arteries of extremities with rest pain

I70.229Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I70.229 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I70.229 in this effective period.

Related Child Codes

Official

I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg

I70.222Atherosclerosis of native arteries of extremities with rest pain, left leg

I70.223Atherosclerosis of native arteries of extremities with rest pain, bilateral legs

I70.228Atherosclerosis of native arteries of extremities with rest pain, other extremity

Includes

Official

any condition classifiable to I70.21-
chronic limb-threatening ischemia NOS of native arteries of extremities
chronic limb-threatening ischemia of native arteries of extremities with rest pain
critical limb ischemia NOS of native arteries of extremities
critical limb ischemia of native arteries of extremities with rest pain

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I70.229 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I70.229 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I70.229 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I70.229 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Clinical diagnosis of peripheral atherosclerosis explicitly documented by the provider

Specification of the affected vessel type (native arteries)

Laterality clearly documented (unspecified extremity)

Documentation of rest pain — ischemic pain occurring at rest, typically in the forefoot, worsening with elevation and improving with dependency

MEAT Support

HCC Buddy guidance

Clinical diagnosis of peripheral atherosclerosis explicitly documented by the provider

Specification of the affected vessel type (native arteries)

Laterality clearly documented (unspecified extremity)

Documentation of rest pain — ischemic pain occurring at rest, typically in the forefoot, worsening with elevation and improving with dependency

Audit Caution

HCC Buddy guidance

Coding bypass graft atherosclerosis codes (I70.3xx-I70.7xx) when the disease is in native arteries — verify whether the patient has a history of bypass graft surgery before selecting the code category

Confusing rest pain with intermittent claudication — rest pain occurs at rest (typically nocturnal forefoot pain relieved by dependency), while claudication is exertional pain relieved by rest

Failing to verify laterality documentation — unspecified laterality codes should be avoided when the affected side is documented in the record

Not querying for more specific findings when rest pain is documented — assess whether ulceration or gangrene is also present, as those would change the code selection to a higher severity category

Common Mistakes

HCC Buddy guidance

I70.3xx (bypass graft series) — Use I70.3xx when atherosclerosis involves a bypass graft rather than native arteries; the graft type must be specified when known

I70.211-I70.219 (native arteries with intermittent claudication) — Claudication is exertional leg pain that resolves with rest, while rest pain occurs even without activity and indicates more severe ischemia

I70.231-I70.25 (native arteries with ulceration) — Use ulceration codes when tissue breakdown is present in addition to or instead of rest pain; if both rest pain and ulceration exist, code the ulceration

I70.261-I70.269 (native arteries with gangrene) — If tissue necrosis is present, gangrene codes take precedence over rest pain codes

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is I70.229 an HCC code?

Yes. I70.229 (Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity) maps to Vascular Disease with Complications under the CMS-HCC V28 risk adjustment model (and Vascular Disease under V24), with a community non-dual aged RAF of 0.455. It is billable for payment year 2026.

Coder answer: I70.229 is billable and maps to V28 HCC 264, Vascular Disease with Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: I70.229
Description: Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
HCC (V28): HCC 264 — Vascular Disease with Complications
RAF: 0.455
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 264, Vascular Disease with Complications

0.455

V24HCC 108, Vascular Disease

0.288

ESRDHCC 108, Vascular Disease

0.073

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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 I70.229 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I70.229

For I70.229 to 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 I70.229 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I70.229 is the ICD-10-CM diagnosis code for atherosclerosis of native arteries of extremities with rest pain, unspecified extremity. This code describes a condition where fatty deposits build up in the arteries of the arms or legs, causing pain even when the person is resting. The specific limb affected is not documented or specified in the medical record. I70.229 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 CMS-HCC V28 risk adjustment model, I70.229 maps to Vascular Disease with Complications (HCC 264) with a community, non-dual, aged base RAF weight of 0.455. Under the older CMS-HCC V24 model, I70.229 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.

Verify documentation specifies rest pain (claudication at rest) rather than exertional pain, as this indicates more severe disease and affects code selection. Because I70.229 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 I70.229 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation specifies rest pain (claudication at rest) rather than exertional pain, as this indicates more severe disease and affects code selection
•If the affected extremity is documented (right leg, left arm, etc.), use a more specific code (I70.221, I70.222, I70.223, or I70.224) rather than the unspecified code 229

Clinical Significance

Atherosclerosis of native arteries with rest pain indicates critical limb ischemia (Fontaine Stage III/Rutherford Category 4), where blood flow is insufficient even at rest. This represents a limb-threatening condition requiring urgent vascular evaluation and intervention to prevent progression to tissue loss or gangrene. Capturing this code accurately reflects disease severity that demands higher levels of care and resource allocation.

Documentation Requirements

✓Clinical diagnosis of peripheral atherosclerosis explicitly documented by the provider
✓Specification of the affected vessel type (native arteries)
✓Laterality clearly documented (unspecified extremity)
✓Documentation of rest pain — ischemic pain occurring at rest, typically in the forefoot, worsening with elevation and improving with dependency
✓Vascular assessment findings such as ankle-brachial index (ABI), pulse examination, or imaging results supporting the diagnosis
✓Current treatment plan including medication management, pain control, and any planned vascular interventions
✓Documentation distinguishing rest pain from claudication (exertional pain) or neuropathic pain

Commonly Confused Codes

•I70.3xx (bypass graft series): Use I70.3xx when atherosclerosis involves a bypass graft rather than native arteries; the graft type must be specified when known
•I70.211-I70.219 (native arteries with intermittent claudication): Claudication is exertional leg pain that resolves with rest, while rest pain occurs even without activity and indicates more severe ischemia
•I70.231-I70.25 (native arteries with ulceration): Use ulceration codes when tissue breakdown is present in addition to or instead of rest pain; if both rest pain and ulceration exist, code the ulceration
•I70.261-I70.269 (native arteries with gangrene): If tissue necrosis is present, gangrene codes take precedence over rest pain codes
•I73.9 (Peripheral vascular disease, unspecified): Avoid this nonspecific code when atherosclerotic peripheral arterial disease with rest pain can be documented specifically