I70.418

HCC Category Mapping

What This Code Means

Fatty buildup in a vein graft of an extremity other than the legs, causing pain during activity that improves with rest.

Coding Tips

• •Apply this code to upper extremities or other non-leg locations with documented intermittent claudication
• •Verify the specific extremity is documented to support this code selection

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)
• ✓Specification of which extremity is affected (upper extremity or other non-lower-extremity site)
• ✓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