I70.618

HCC Category Mapping

What This Code Means

Hardening and narrowing of an artificial blood vessel graft in an arm or other extremity (not the legs) causing pain or cramping during activity that goes away with rest.

Coding Tips

• •Use this code for upper extremity or other non-leg locations with intermittent claudication symptoms.
• •Document the specific extremity location in the medical record for clarity and future reference.

Clinical Significance

This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities with intermittent claudication in the other extremity (e.g., upper 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 (other extremity (e.g., upper 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

Commonly Confused Codes