I70.25

Billable

Atherosclerosis of native arteries of other extremities with ulceration

HCC Category Mapping

RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer

0.000

What This Code Means

Hardening of arteries in other body extremities (such as arms or fingers) with open sores or ulcers due to reduced blood flow.

Coding Tips

•Use this code only when the affected extremity is not the legs; document which extremity is involved
•Confirm ulceration is directly related to atherosclerotic disease, not other etiologies

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 (other extremities)
✓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

Includes

any condition classifiable to I70.218 and I70.228

Use Additional Code

code to identify the severity of the ulcer (L98.49-)

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 I70.221-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 component L97.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 severity I70.261-I70.269 (native arteries with gangrene) — If gangrene is present along with ulceration, code the gangrene category as it represents greater severity E11.621 (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 └I70.25Atherosclerosis of native arteries of other extremities with ulceration

└I70.25Atherosclerosis of native arteries of other extremities with ulceration