I70.469
BillableAtherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity
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 an unspecified extremity, resulting in tissue death (gangrene).
Coding Tips
- •Use this code only when the specific extremity location cannot be determined from documentation.
- •Query the provider if the affected extremity is not clearly documented, as more specific codes are preferred.
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
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 veinI70.6xx — Nonbiological bypass graft codes; use when a synthetic graft material (such as Dacron or polytetrafluoroethylene) is used rather than a veinI70.2xx — Native artery atherosclerosis codes; use when no bypass graft is present and disease is in the patient's own arteriesI70.42x — Atherosclerosis of same graft type with rest pain; use when there is critical ischemia pain but no tissue necrosisI96 — Gangrene not elsewhere classified; use only when gangrene is not attributable to atherosclerosis or peripheral arterial diseaseE08.52-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└I70.469Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity
└I70.469Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity