I70.435

Billable

Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot

HCC Category Mapping

RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer

0.000

What This Code Means

This code describes a condition where fatty deposits have built up in a vein graft that was surgically placed in the right leg to bypass a blocked artery, and this buildup has caused an open sore or ulcer to develop on another part of the foot. This is a serious circulatory problem that requires medical attention.

Coding Tips

•Verify documentation specifies the graft is autologous (patient's own vein) and clearly identifies the right leg as the affected side
•Confirm the ulceration location is documented as 'other part of foot' (not heel, midfoot, or toe) and ensure the ulcer severity/depth is documented to assign the appropriate 5th character if needed

Clinical Significance

This code identifies atherosclerosis in autologous vein bypass grafts with ulceration of other part of foot, indicating significant peripheral arterial insufficiency causing tissue breakdown. Ulceration complicating bypass graft atherosclerosis signals graft stenosis or failure with inadequate distal perfusion, requiring wound care management and potential revascularization. Accurate capture matters for risk adjustment as it reflects the progression from stable peripheral arterial disease to limb-threatening ischemia.

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)
✓Laterality clearly stated as right leg
✓Ulcer site specifically documented (in this case, other part of foot)
✓Ulcer severity, size, and depth documented (consider Wound, Ischemia, and foot Infection classification or similar staging)
✓Causal link between atherosclerotic graft disease and the ulceration must be established in the documentation
✓Current wound care plan and treatment documented
✓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 L97.xxx (non-pressure chronic ulcer of lower limb) — Use L97 as an additional code for ulcer severity/laterality, but the primary etiology code should be the I70 code when atherosclerosis is the underlying cause

Code Hierarchy

└I70Atherosclerosis └I70.4Atherosclerosis of autologous vein bypass graft(s) of the extremities └I70.43Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration └I70.435Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot

└I70.435Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration of other part of foot