I70.542
BillableAtherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf
HCC Category Mapping
RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer
0.000What This Code Means
Hardening of arteries in a biological bypass graft in the left leg with an open sore on the calf.
Coding Tips
- •Ensure documentation clearly identifies the ulceration location as the calf region of the left leg.
- •Confirm the bypass graft is nonautologous biological material, not synthetic or autologous.
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 left 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 tissueI70.6xx — Nonbiological bypass graft codes; use when a synthetic graft material (such as Dacron or polytetrafluoroethylene) is used rather than biological tissueI70.2xx — Native artery atherosclerosis codes; use when no bypass graft is present and disease is in the patient's own arteriesL97.xxx — Non-pressure chronic ulcer of lower limb; use when the ulcer is not caused by atherosclerotic diseaseL98.499 — 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└I70.54Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration└I70.542Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf
└I70.542Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration of calf