I70.538

Billable

Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg

HCC Category Mapping

RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer

0.000

What This Code Means

Hardening of arteries in a biological bypass graft in the right leg with an open sore in another part of the lower leg (not thigh, calf, or ankle).

Coding Tips

•Use this code when the ulcer location is documented but does not fit the more specific anatomical categories
•Document the exact location of the ulcer (e.g., shin, foot, heel) for clinical clarity

Clinical Significance

This code identifies atherosclerosis of a nonautologous biological bypass graft with ulceration, representing advanced peripheral arterial disease where compromised blood flow has caused tissue breakdown. Ulceration in the setting of bypass graft atherosclerosis indicates graft failure or progression of disease beyond the graft, requiring aggressive wound care and potential revascularization. This diagnosis carries significant implications for patient morbidity and healthcare resource consumption.

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)
✓Description of the ulcer including location, size, depth, and wound bed characteristics
✓Documentation linking the ulceration to the atherosclerotic bypass graft disease
✓Vascular assessment results confirming arterial insufficiency as the cause
✓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 L97.xxx — Non-pressure chronic ulcer of lower limb; use when the ulcer is not caused by atherosclerotic disease L98.499 — Non-pressure chronic ulcer of skin of other sites; use for ulcers unrelated to peripheral arterial disease

Code Hierarchy

└I70Atherosclerosis └I70.5Atherosclerosis of nonautologous biological bypass graft(s) of the extremities └I70.53Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration └I70.538Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg

└I70.538Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration of other part of lower leg