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I70.65

Billable

Atherosclerosis of nonbiological bypass graft(s) of other extremity with ulceration

HCC Category Mapping

RxHCCHCC 311Diabetic and Chronic Skin Ulcer
0.000

What This Code Means

Hardening of arteries in a synthetic bypass graft affecting other body parts (not the legs) with an open sore.

Coding Tips

  • This code applies to nonbiological bypass grafts in extremities other than the legs (such as arms)
  • Ensure documentation specifies the extremity location and confirms the presence of ulceration

Clinical Significance

This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities with ulceration of the affected extremity in the other extremity (e.g., upper 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 (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
  • Ulcer location specifically documented (e.g., the affected extremity)
  • 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

Includes

Use Additional Code

  • code to identify severity of ulcer (L98.49)

Commonly Confused Codes

Code Hierarchy

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