I70.243
BillableAtherosclerosis of native arteries of left leg with ulceration of ankle
HCC Category Mapping
RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer
0.000What This Code Means
Hardening and narrowing of arteries in the left leg that has caused an open sore or ulcer on the ankle.
Coding Tips
- •Ensure documentation clearly indicates left leg and ankle location
- •Distinguish ankle ulcers from heel/midfoot ulcers, which have separate codes
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 (left leg)
- ✓Documentation of the ulcer location (ankle) 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
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 knownI70.221-I70.229 (native arteries with rest pain) — Use rest pain codes only when there is no ulceration or gangrene present; ulceration codes include the rest pain componentL97.x (Non-pressure chronic ulcer of lower limb) — L97 codes describe ulcers not specified as due to atherosclerosis; use I70.23x-I70.25 when the ulcer is clearly arterial in etiology. An additional L97 code may be assigned for ulcer severityI70.261-I70.269 (native arteries with gangrene) — If gangrene is present along with ulceration, code the gangrene category as it represents greater severityE11.621 (Type 2 diabetes mellitus with foot ulcer) — Diabetic foot ulcers are coded differently; if both atherosclerosis and diabetes contribute, both conditions should be coded
Code Hierarchy
└I70Atherosclerosis└I70.2Atherosclerosis of native arteries of the extremities└I70.24Atherosclerosis of native arteries of left leg with ulceration└I70.243Atherosclerosis of native arteries of left leg with ulceration of ankle
└I70.243Atherosclerosis of native arteries of left leg with ulceration of ankle