I70.638

Billable

Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg

HCC Category Mapping

RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer

0.000

What This Code Means

Hardening of arteries in a synthetic bypass graft of the right leg with an open sore on other parts of the lower leg.

Coding Tips

•This code is for lower leg ulcerations not on the thigh, calf, or ankle
•Ensure the ulceration location is documented as lower leg rather than foot or thigh

Clinical Significance

This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities with ulceration of other part of the lower leg in the right lower extremity, indicating Fontaine Stage III-IV peripheral arterial disease. Ulceration in the setting of bypass graft atherosclerosis reflects inadequate distal perfusion despite prior surgical revascularization, suggesting graft compromise or disease progression. These patients require complex wound management, serial vascular assessments, and potential graft revision or amputation.

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
✓Ulcer location specifically documented (e.g., other part of the lower leg)
✓Ulcer characteristics: size, depth, stage/grade, wound bed description
✓Vascular etiology confirmed — distinguishing from diabetic, venous, or pressure ulcers
✓Wound care treatment plan and follow-up schedule
✓Consider additional code for ulcer severity (L97.- or L98.-) as applicable

Commonly Confused Codes

I70.531-I70.549 — Atherosclerosis of nonautologous biological bypass graft with ulceration; different graft material I70.431-I70.449 — Atherosclerosis of autologous vein bypass graft with ulceration; for saphenous or other autologous vein grafts I70.331-I70.349 — Atherosclerosis of unspecified bypass graft with ulceration; only when graft type is undocumented I70.231-I70.249 — Atherosclerosis of native arteries with ulceration; for native vessel disease, not bypass grafts L97.x — Non-pressure chronic ulcer of lower limb; may be needed as additional code for ulcer severity

Code Hierarchy

└I70Atherosclerosis └I70.6Atherosclerosis of nonbiological bypass graft(s) of the extremities └I70.63Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration └I70.638Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg

└I70.638Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration of other part of lower leg