I70.721
BillableAtherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg
HCC Category Mapping
V28HCC 264 — Vascular Disease with Complications
0.356V24HCC 108 — Vascular Disease
0.297ESRDHCC 108 — Vascular Disease
0.000What This Code Means
Hardening and narrowing of a bypass graft in the right leg causing pain at rest due to poor blood flow.
Coding Tips
- •Verify documentation specifies 'rest pain' and confirms right leg involvement
- •Ensure the bypass graft type is documented as 'other type' (not autologous vein or nonautologous biological)
Clinical Significance
This code captures atherosclerosis affecting other type 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 other type 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
I70.621-I70.629 — Atherosclerosis of nonbiological bypass graft with rest pain; specifically for synthetic graftsI70.521-I70.529 — Atherosclerosis of nonautologous biological bypass graft with rest pain; for cadaveric or bovine graftsI70.421-I70.429 — Atherosclerosis of autologous vein bypass graft with rest pain; for patient's own vein graftI70.321-I70.329 — Atherosclerosis of unspecified bypass graft with rest pain; use only when graft type is not documentedI70.221-I70.229 — Atherosclerosis of native arteries with rest pain; for native vessel disease without graft involvement
Code Hierarchy
└I70Atherosclerosis└I70.7Atherosclerosis of other type of bypass graft(s) of the extremities└I70.72Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain└I70.721Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg
└I70.721Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg