I70.611
BillableAtherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, right leg
HCC Category Mapping
What This Code Means
Hardening and narrowing of an artificial blood vessel graft in the right leg causing leg pain or cramping during walking that goes away with rest.
Coding Tips
- •Intermittent claudication is characterized by reproducible leg pain with activity that resolves with rest; ensure this symptom is documented.
- •The '611' specifically indicates right leg involvement; do not use if the condition affects both legs or the left leg only.
Clinical Significance
This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities with intermittent claudication in the right lower extremity, representing Fontaine Stage II peripheral arterial disease. Claudication in the context of bypass graft atherosclerosis indicates graft stenosis or progressive native vessel disease causing reproducible exercise-induced muscle pain. While less immediately threatening than rest pain or gangrene, this signals graft compromise requiring surveillance duplex imaging and potential intervention.
Documentation Requirements
- ✓Confirmed diagnosis of atherosclerosis affecting nonbiological (synthetic) bypass graft(s)
- ✓Type of bypass graft material documented (synthetic/nonbiological vs. other type such as composite or mixed-material graft)
- ✓Laterality clearly documented (right lower extremity)
- ✓History of bypass graft surgery with approximate date or timeframe
- ✓Current status and monitoring plan for the bypass graft
- ✓Documentation of exercise-induced muscle pain with specific walking distance or duration before onset
- ✓Relief of symptoms with rest and reproduction with activity
- ✓Vascular studies (ankle-brachial index at rest and post-exercise) confirming arterial etiology
- ✓Differentiation from spinal stenosis (neurogenic claudication) and other causes of leg pain with activity