I70.613

HCC Category Mapping

What This Code Means

Hardening and narrowing of artificial blood vessel grafts in both legs causing leg pain or cramping during walking that goes away with rest.

Coding Tips

• •This code requires documentation of bilateral leg involvement; ensure both legs are affected before assigning.
• •When bilateral claudication is present, use only this code; do not code right and left separately.

Clinical Significance

This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities with intermittent claudication in the bilateral lower extremities, 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 (bilateral lower extremities)
• ✓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

Commonly Confused Codes