Skip to content

I70.334 ICD-10-CM Code: Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

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

I70.334

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

Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot

Hardening and narrowing of a bypass graft in the right leg with an open sore on the heel or midfoot area.

Buddy the Bee presenting code insight

Buddy Insight

Atherosclerosis of bypass graft(s) with ulceration indicates severe peripheral arterial disease (Fontaine Stage IV/Rutherford Category 5) where impaired blood flow has caused tissue breakdown.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

HCC 311

RAF 0.0

Code Trumping

Basket needed

Code Book Path

Official
I70.3Atherosclerosis of unspecified type of bypass graft(s) of the extremities
I70.33Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration
I70.334Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot

Inclusion Terms

Official
  • Atherosclerosis of unspecified type of bypass graft(s) of right leg with ulceration of plantar surface of midfoot

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I70.334 in this effective period.

Related Child Codes

Official
I70.331Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of thigh
I70.332Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of calf
I70.333Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of ankle
I70.335Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of foot
I70.338Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of lower leg

Includes

Official
  • any condition classifiable to I70.311 and I70.321
  • chronic limb-threatening ischemia of unspecified type of bypass graft(s) of the right leg with ulceration
  • critical limb ischemia of unspecified type of bypass graft(s) of the right leg with ulceration

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I70.334 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I70.334 in this effective period.

Use Additional

Official
  • code to identify severity of ulcer (L97.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for I70.334 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 (bypass graft(s))
Laterality clearly documented (right leg)
Documentation of the ulcer location (heel and midfoot) with description of size, depth, and wound characteristics

MEAT Support

HCC Buddy guidance
Clinical diagnosis of peripheral atherosclerosis explicitly documented by the provider
Specification of the affected vessel type (bypass graft(s))
Laterality clearly documented (right leg)
Documentation of the ulcer location (heel and midfoot) with description of size, depth, and wound characteristics

Audit Caution

HCC Buddy guidance
Using native artery codes (I70.2xx) when the patient has a documented bypass graft — always verify surgical history and code to the appropriate graft category
Defaulting to unspecified graft type when the medical record documents the specific graft type (autologous vein, nonnautologous biological, or nonbiological) — query the record for graft details before coding to unspecified
Failing to document the specific ulcer site (heel and midfoot) — the code requires specificity of the anatomic location of the ulcer
Coding a venous stasis ulcer or diabetic neuropathic ulcer as an atherosclerotic arterial ulcer — the etiology must be confirmed as arterial insufficiency from atherosclerosis

Common Mistakes

HCC Buddy guidance
I70.2xx (native artery series) — Use I70.2xx when atherosclerosis involves the native arteries rather than a bypass graft; do not use bypass graft codes without documentation of prior graft surgery
I70.321-I70.329 (bypass graft with rest pain) — Use rest pain codes only when there is no ulceration; ulceration represents a more advanced manifestation
L97.x (Non-pressure chronic ulcer of lower limb) — L97 codes are for ulcers without specified atherosclerotic etiology; an additional L97 code may be used to identify ulcer severity
I70.361-I70.369 (bypass graft with gangrene) — Gangrene codes take precedence when tissue necrosis is present alongside ulceration

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is I70.334 an HCC code?

No. I70.334 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 311, Diabetic and Chronic Skin Ulcer
0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.

MEAT Criteria for I70.334

For I70.334to 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 I70.334 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

I70.334 is the ICD-10-CM diagnosis code for atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot. Hardening and narrowing of a bypass graft in the right leg with an open sore on the heel or midfoot area. I70.334 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).

I70.334 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code does not map to an HCC under the CMS-HCC V28 model. It does not map to an HCC under the CMS-HCC V24 model. It does not map to an HCC under the ESRD model. In the RxHCC model, it maps to RxHCC 311 but carries a RAF weight of 0.0, meaning it is recognized for prescription drug risk adjustment but does not independently increase the RAF score. While these ulceration codes do not map to CMS-HCC V24 or V28 directly, they are recognized in the RxHCC model. The ulceration indicates significant disease severity that should be captured for complete clinical documentation even when HCC impact is limited.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I70.334 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code combines heel and midfoot locations; verify the ulcer is in one of these specific areas
  • Heel ulcers are common in diabetic patients; ensure proper documentation of comorbidities

Clinical Significance

Atherosclerosis of bypass graft(s) 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 (bypass graft(s))
  • Laterality clearly documented (right leg)
  • Documentation of the ulcer location (heel and midfoot) 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
  • Documentation of prior bypass graft surgery with type of graft if known (autologous vein, nonnautologous biological, or nonbiological — code to specific graft type when documented)

Commonly Confused Codes

  • I70.2xx (native artery series): Use I70.2xx when atherosclerosis involves the native arteries rather than a bypass graft; do not use bypass graft codes without documentation of prior graft surgery
  • I70.321-I70.329 (bypass graft with rest pain): Use rest pain codes only when there is no ulceration; ulceration represents a more advanced manifestation
  • L97.x (Non-pressure chronic ulcer of lower limb): L97 codes are for ulcers without specified atherosclerotic etiology; an additional L97 code may be used to identify ulcer severity
  • I70.361-I70.369 (bypass graft with gangrene): Gangrene codes take precedence when tissue necrosis is present alongside ulceration
  • I70.431-I70.45, I70.531-I70.55, I70.631-I70.65 (specific graft type with ulceration): Code to the specific graft type when documented

Child Codes

Code Hierarchy

More on I70.334

Related condition guides

Open I70.334 in the Interactive Encoder

See full code details, coding tips, HCC mappings, and related codes in our interactive encoder. Start your 14-day Pro trial. No credit card required.