I70.621

Billable

Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg

HCC Category Mapping

V28HCC 264 — Vascular Disease with Complications

0.356

V24HCC 108 — Vascular Disease

0.297

ESRDHCC 108 — Vascular Disease

0.000

What This Code Means

Hardening and narrowing of an artificial blood vessel graft in the right leg causing pain even at rest, indicating severe circulation problems.

Coding Tips

•Rest pain is a more severe symptom than intermittent claudication; ensure the pain occurs without activity or with minimal activity.
•Rest pain codes (62x) indicate more advanced disease than claudication codes (61x); verify symptom severity is accurately documented.

Clinical Significance

This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities with rest pain in the right lower extremity, representing Fontaine Stage III/Rutherford Category 4 critical limb ischemia. Rest pain in bypass graft atherosclerosis indicates severe ischemia at rest, signifying graft failure or progressive disease beyond the graft, with high risk of tissue loss. This condition requires urgent vascular evaluation, potential graft revision or new revascularization, and aggressive risk factor modification.

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 pain occurring at rest, typically worse with leg elevation and relieved by dependency
✓Vascular studies confirming critical limb ischemia (reduced ankle-brachial index, toe pressures, or transcutaneous oxygen measurements)
✓Differentiation from neuropathic pain, musculoskeletal pain, or other etiologies
✓Treatment plan including consideration for revascularization

Commonly Confused Codes

I70.521-I70.529 — Atherosclerosis of nonautologous biological bypass graft with rest pain; different graft material (cadaveric, bovine)I70.421-I70.429 — Atherosclerosis of autologous vein bypass graft with rest pain; for patient's own vein graft I70.321-I70.329 — Atherosclerosis of unspecified bypass graft with rest pain; use only when graft type is not documented I70.221-I70.229 — Atherosclerosis of native arteries with rest pain; for native vessel disease without graft involvement I70.721-I70.729 — Atherosclerosis of other type of bypass graft with rest pain; for composite or non-standard grafts

Code Hierarchy

└I70Atherosclerosis └I70.6Atherosclerosis of nonbiological bypass graft(s) of the extremities └I70.62Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain └I70.621Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg

└I70.621Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg