I70.239

HCC Category Mapping

What This Code Means

Hardening and narrowing of arteries in the right leg with an open sore or ulcer, but the exact location on the leg or foot is not specified.

Coding Tips

• •Only assign this code when documentation does not specify the ulcer location
• •Query the provider for specific ulcer location to assign a more specific code if possible

Clinical Significance

Atherosclerosis of native arteries with ulceration indicates severe peripheral arterial disease (Fontaine Stage IV/Rutherford Category 5) where impaired blood flow has caused tissue breakdown. These arterial ulcers require specialized wound care, vascular assessment, and often revascularization to promote healing and prevent amputation. This combination code captures both the underlying vascular disease and the ulcerative complication, reflecting the increased care complexity and resource needs.

Documentation Requirements

• ✓Clinical diagnosis of peripheral atherosclerosis explicitly documented by the provider
• ✓Specification of the affected vessel type (native arteries)
• ✓Laterality clearly documented (right leg)
• ✓Documentation of the ulcer location (unspecified site) with description of size, depth, and wound characteristics
• ✓Confirmation that the ulcer is arterial in etiology (as opposed to venous, diabetic neuropathic, or pressure ulcer)
• ✓Wound assessment details including wound bed description, drainage, presence of infection, and staging if applicable
• ✓Vascular assessment findings (ankle-brachial index, pulse examination, or arterial Doppler studies) supporting ischemic etiology
• ✓Current wound care and vascular treatment plan

Commonly Confused Codes