I70.269
BillableAtherosclerosis of native arteries of extremities with gangrene, unspecified extremity
HCC Category Mapping
V28HCC 263 — Atherosclerosis of the Extremities with Ulceration or Gangrene
0.742V24HCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene
0.860ESRDHCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene
0.000What This Code Means
Hardening of arteries in an unspecified extremity with tissue death (gangrene) due to poor blood circulation.
Coding Tips
- •This is a less specific code; attempt to obtain documentation specifying which extremity is affected
- •Use only when the specific extremity location cannot be determined from available documentation
Clinical Significance
Atherosclerosis of native arteries with gangrene represents the most severe stage of peripheral arterial disease (Fontaine Stage IV/Rutherford Category 5-6), indicating tissue death due to critical limb ischemia. This diagnosis carries extremely high morbidity with significant risk of amputation, sepsis, and mortality, requiring urgent vascular intervention. Accurate capture is essential for risk adjustment as it reflects the highest severity of peripheral vascular disease and drives substantial resource utilization.
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)
- ✓Explicit documentation of gangrene — type (dry or wet), extent, and anatomic location
- ✓Confirmation that gangrene is due to atherosclerotic peripheral arterial disease
- ✓Vascular assessment findings documenting the severity of arterial insufficiency
- ✓Current treatment plan including surgical consultation, debridement, revascularization, or amputation considerations
- ✓Assessment for sepsis or systemic infection if wet gangrene is present
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 knownI70.231-I70.25 (native arteries with ulceration) — Gangrene codes represent more severe tissue damage than ulceration alone; do not downcode to ulceration when gangrene is documentedI70.221-I70.229 (native arteries with rest pain) — Rest pain codes are insufficient when gangrene has developed; gangrene codes already encompass the lower severity stagesI96 (Gangrene, not elsewhere classified) — Do not use this nonspecific gangrene code when the etiology is atherosclerotic peripheral arterial diseaseR02 (Gangrene, not elsewhere classified — legacy) — This code is no longer valid; use the combination code that identifies both the atherosclerosis and gangreneE11.52 (Type 2 diabetes with diabetic peripheral angiopathy with gangrene) — Use this code when gangrene is attributed to diabetic peripheral angiopathy rather than primary atherosclerosis
Code Hierarchy
└I70Atherosclerosis└I70.2Atherosclerosis of native arteries of the extremities└I70.26Atherosclerosis of native arteries of extremities with gangrene└I70.269Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity
└I70.269Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity