I70.413

Billable

Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs

HCC Category Mapping

V24HCC 108 — Vascular Disease

0.297

ESRDHCC 108 — Vascular Disease

0.000

What This Code Means

This condition occurs when fatty deposits build up inside surgically placed vein grafts (veins taken from the patient's own body) that bypass blocked arteries in both legs, causing leg pain and cramping during walking that goes away with rest. The blockage restricts blood flow to the leg muscles, resulting in intermittent claudication (pain with activity).

Coding Tips

•Verify documentation specifies 'autologous vein bypass graft' and confirms bilateral involvement of both legs to support the .413 code selection
•Ensure the clinical record documents intermittent claudication symptoms and confirms this is atherosclerosis of the graft itself, not the native vessel, as this affects laterality and graft type coding

Clinical Significance

This code identifies atherosclerosis in autologous vein bypass grafts with intermittent claudication, where exertional leg pain occurs due to insufficient blood flow during activity. Claudication in bypass grafts indicates developing graft stenosis or disease progression proximal or distal to the graft. While less acute than rest pain or ulceration, this condition impacts functional status and predicts future vascular events, making it relevant for risk adjustment.

Documentation Requirements

✓Documentation of peripheral arterial disease or atherosclerosis affecting the bypass graft
✓Identification of graft type as autologous vein (if autologous vein is confirmed, document the vein source; if type is unknown, document it as unspecified)
✓Bilateral involvement documented
✓Claudication symptoms described (pain with walking, relieved by rest)
✓Walking distance at onset of symptoms when available
✓Ankle-brachial index or vascular imaging results supporting the diagnosis
✓History of bypass graft surgery with date and indication when available

Commonly Confused Codes

I70.3xx (unspecified type bypass graft codes) — Use I70.3xx when the graft type is not documented; use I70.4xx (autologous vein) only when the graft is confirmed as the patient's own vein I70.5xx (nonautologous biological bypass graft codes) — Use when the graft is a biological material from a donor (cadaveric vein, bovine graft), not the patient's own vein I70.6xx (nonbiological bypass graft codes) — Use for synthetic grafts such as polytetrafluoroethylene or Dacron, not for autologous vein grafts I70.2xx (native artery atherosclerosis codes) — Use for atherosclerosis of native arteries, not bypass grafts; verify whether disease is in the graft or native vessel

Code Hierarchy

└I70Atherosclerosis └I70.4Atherosclerosis of autologous vein bypass graft(s) of the extremities └I70.41Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication └I70.413Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs

└I70.413Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, bilateral legs