I70.663

Billable

Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs

HCC Category Mapping

V28HCC 263 — Atherosclerosis of the Extremities with Ulceration or Gangrene

0.742

V24HCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene

0.860

ESRDHCC 106 — Atherosclerosis of the Extremities with Ulceration or Gangrene

0.000

What This Code Means

Hardening of arteries in synthetic bypass grafts affecting both legs with tissue death (gangrene) in both.

Coding Tips

•This code requires documentation of bilateral gangrene in both legs with nonbiological bypass grafts
•Bilateral gangrene represents severe disease and typically requires urgent surgical intervention

Clinical Significance

This code captures atherosclerosis affecting nonbiological (synthetic) bypass graft(s) of the extremities complicated by gangrene in the bilateral lower extremities, representing the most severe stage of peripheral arterial disease (Fontaine Stage IV/Rutherford Category 5-6). Gangrene in bypass graft atherosclerosis indicates critical limb ischemia with tissue death, carrying high risk for amputation, sepsis, and mortality. This diagnosis significantly impacts risk adjustment due to the intensive surgical, wound care, and vascular management required.

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 gangrene: location, extent, wet vs. dry, and tissue involvement
✓Vascular studies (ankle-brachial index, duplex ultrasound, or angiography) confirming critical ischemia
✓Wound care plan and surgical consultation documentation
✓Assessment of amputation risk and level if applicable

Commonly Confused Codes

I70.561-I70.569 — Atherosclerosis of nonautologous biological bypass graft with gangrene; different graft material (cadaveric vein, bovine)I70.461-I70.469 — Atherosclerosis of autologous vein bypass graft with gangrene; for patient's own vein graft (e.g., saphenous vein)I70.361-I70.369 — Atherosclerosis of unspecified bypass graft with gangrene; use only when graft type is unknown I70.261-I70.269 — Atherosclerosis of native arteries with gangrene; for disease in native vessels, not grafts I70.761-I70.769 — Atherosclerosis of other type of bypass graft with gangrene; for composite or other non-standard graft materials I96 — Gangrene, not elsewhere classified; do not use when the gangrene is specified as atherosclerotic

Code Hierarchy

└I70Atherosclerosis └I70.6Atherosclerosis of nonbiological bypass graft(s) of the extremities └I70.66Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene └I70.663Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs

└I70.663Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene, bilateral legs