I70.461
BillableAtherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg
HCC Category Mapping
V28HCC 263 — Atherosclerosis of the Extremities with Ulceration or Gangrene
0.742V24HCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene
0.860ESRDHCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene
0.000What This Code Means
Hardening of arteries in a vein graft used to bypass a blocked artery in the right leg, resulting in tissue death (gangrene).
Coding Tips
- •Gangrene is a serious complication requiring immediate clinical attention and should be clearly documented.
- •Verify laterality (right leg) in the medical record to ensure correct code assignment.
Clinical Significance
This code captures atherosclerotic disease in autologous vein bypass grafts complicated by gangrene, representing the most severe manifestation of peripheral arterial disease with tissue death. Gangrene in bypass grafts indicates graft failure or progression of disease beyond the graft, carrying high risk for limb amputation and systemic sepsis. This diagnosis demands urgent vascular intervention and reflects extremely high disease burden for risk adjustment purposes.
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
- ✓Gangrene explicitly documented with location and extent
- ✓Type of gangrene specified (dry, wet, or gas gangrene) when possible
- ✓Causal relationship between graft atherosclerosis and gangrene established
- ✓Current treatment plan including any planned amputation or revascularization
- ✓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 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 vesselI70.26x/I70.36x (same graft type without gangrene, with ulceration only) — Gangrene codes are more specific and carry higher risk adjustment weight; do not downcode to ulceration when gangrene is documentedR02 (gangrene, not elsewhere classified) — Use the I70 combination code rather than a separate gangrene code when atherosclerosis is the underlying etiology
Code Hierarchy
└I70Atherosclerosis└I70.4Atherosclerosis of autologous vein bypass graft(s) of the extremities└I70.46Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene└I70.461Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg
└I70.461Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg