I70.468

Billable

Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity

HCC Category Mapping

V28HCC 263 — Atherosclerosis of the Extremities with Ulceration or Gangrene

0.742

V24HCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene

0.860

ESRDHCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene

0.000

What This Code Means

This code describes a serious condition where fatty deposits have built up in a vein graft (a surgically placed blood vessel from the patient's own vein) in the leg or arm, causing tissue death (gangrene) in that limb. This is a complication of a previous bypass surgery.

Coding Tips

•Verify the graft type is autologous vein (not synthetic or allograft) and confirm gangrene is documented as present before assigning this code
•This code requires documentation of the specific extremity affected; use the 5th character to specify which limb (right/left leg or arm) and ensure gangrene severity is clearly stated in the medical record

Clinical Significance

This code captures atherosclerosis of a autologous vein bypass graft in the extremities complicated by gangrene, representing the most severe form of peripheral arterial disease with tissue necrosis. Gangrene indicates critical limb ischemia with irreversible tissue damage, often necessitating amputation and carrying significant mortality risk. Accurate capture is essential for risk adjustment as it reflects extremely high disease burden and resource utilization.

Documentation Requirements

✓Documentation of the type of bypass graft as autologous vein (must distinguish from autologous vein, nonautologous biological, or synthetic/nonbiological grafts)
✓Clinical evidence of atherosclerosis affecting the bypass graft (imaging, angiography, or clinical assessment)
✓Documentation of gangrene with description of extent and affected tissue
✓Assessment of the affected extremity including viability of surrounding tissue
✓Vascular study results (such as ankle-brachial index, arterial duplex, or angiography) demonstrating compromised graft flow
✓Documentation specifying which extremity is affected (for example, upper extremity)

Commonly Confused Codes

I70.5xx — Nonautologous biological bypass graft codes; use when the graft is from a donor or animal tissue, not the patient's own vein I70.6xx — Nonbiological bypass graft codes; use when a synthetic graft material (such as Dacron or polytetrafluoroethylene) is used rather than a vein I70.2xx — Native artery atherosclerosis codes; use when no bypass graft is present and disease is in the patient's own arteries I70.42x — Atherosclerosis of same graft type with rest pain; use when there is critical ischemia pain but no tissue necrosis I96 — Gangrene not elsewhere classified; use only when gangrene is not attributable to atherosclerosis or peripheral arterial disease E08.52-E13.52 — Diabetic peripheral angiopathy with gangrene; use when gangrene is a complication of diabetes rather than bypass graft atherosclerosis

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 └I70.468Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity

└I70.468Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity