I70.45
BillableAtherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration
HCC Category Mapping
RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer
0.000What This Code Means
Hardening of arteries in a vein graft used to bypass a blocked artery in an extremity other than the legs, with an open sore.
Coding Tips
- •Use this code when the affected extremity is not the leg (e.g., arm or other extremity).
- •Ensure documentation clearly identifies which extremity is affected to support medical necessity.
Clinical Significance
This code identifies atherosclerosis in autologous vein bypass grafts with ulceration of the affected area, 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)
- ✓Specification of which extremity is affected (upper extremity or other non-lower-extremity site)
- ✓Ulcer site specifically documented (in this case, the site)
- ✓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
Use Additional Code
- code to identify severity of ulcer (L98.49)
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 veinI70.5xx (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 veinI70.6xx (nonbiological bypass graft codes) — Use for synthetic grafts such as polytetrafluoroethylene or Dacron, not for autologous vein graftsI70.2xx (native artery atherosclerosis codes) — Use for atherosclerosis of native arteries, not bypass grafts; verify whether disease is in the graft or native vesselL97.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└I70.45Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration
└I70.45Atherosclerosis of autologous vein bypass graft(s) of other extremity with ulceration