I70.511

Billable

Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, right leg

HCC Category Mapping

V24HCC 108 — Vascular Disease

0.297

ESRDHCC 108 — Vascular Disease

0.000

What This Code Means

Plaque buildup in a nonautologous biological bypass graft in the right leg causing intermittent claudication (leg pain or cramping during walking that improves with rest).

Coding Tips

•Intermittent claudication is a key symptom that elevates this to a more specific code; ensure it is documented
•Distinguish from rest pain or tissue loss, which would use different codes in the I70.52x or I70.53x series

Clinical Significance

This code identifies atherosclerosis of a nonautologous biological bypass graft with intermittent claudication, indicating that the bypass graft has developed atherosclerotic narrowing causing exercise-induced leg pain. Intermittent claudication in a bypass graft suggests graft stenosis or progression of disease, which may require surveillance imaging and potential reintervention. The code corresponds to Fontaine Stage IIa/IIb (intermittent claudication), indicating functional limitation but not yet critical limb ischemia. While less immediately threatening than rest pain or gangrene, this condition significantly impacts functional status and quality of life.

Documentation Requirements

✓Documentation of the type of bypass graft as nonautologous biological (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 exercise-induced leg pain that resolves with rest (classic claudication pattern)
✓Walking distance or functional limitation assessment
✓Vascular studies confirming hemodynamically significant stenosis in the bypass graft
✓Clear documentation of laterality specifying the right leg

Commonly Confused Codes

I70.4xx — Autologous vein bypass graft codes; use when the graft is the patient's own harvested vein, not donor or animal tissue I70.6xx — Nonbiological bypass graft codes; use when a synthetic graft material (such as Dacron or polytetrafluoroethylene) is used rather than biological tissue I70.2xx — Native artery atherosclerosis codes; use when no bypass graft is present and disease is in the patient's own arteries M79.609 — Pain in unspecified limb; do not use when claudication is caused by peripheral arterial disease G57.xx — Mononeuropathies of lower limb; differentiate neurogenic claudication from vascular claudication

Code Hierarchy

└I70Atherosclerosis └I70.5Atherosclerosis of nonautologous biological bypass graft(s) of the extremities └I70.51Atherosclerosis of nonautologous biological bypass graft(s) of the extremities intermittent claudication └I70.511Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, right leg

└I70.511Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with intermittent claudication, right leg