I70.722 ICD-10-CM Code: Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg
I70.722 maps to CMS-HCC V28 264. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of arteries, arterioles and capillaries (I70-I79)
I70.722
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAtherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg
Hardening and narrowing of a bypass graft in the left leg causing pain at rest due to poor blood flow.
Buddy Insight
This code captures atherosclerosis affecting other type bypass graft(s) of the extremities with rest pain in the left lower extremity, representing Fontaine Stage III/Rutherford Category 4 critical limb ischemia.
CMS-HCC V28
MappedHCC 264
Coefficient HCC 264: 0.455 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
Context neededHCC 108
Coefficient needs member context
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for I70.722. Check the code and parent instructions in the Code Book.
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from I00-I99, I70
- certain infectious and parasitic diseases (A00-B99)Inherited from I00-I99, I70
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from I00-I99, I70
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from I00-I99, I70
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from I00-I99, I70
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from I00-I99, I70
- neoplasms (C00-D49)Inherited from I00-I99, I70
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from I00-I99, I70
- systemic connective tissue disorders (M30-M36)Inherited from I00-I99, I70
- transient cerebral ischemic attacks and related syndromes (G45.-)Inherited from I00-I99, I70
- arteriosclerotic cardiovascular disease (I25.1-)Inherited from I00-I99, I70
- arteriosclerotic heart disease (I25.1-)Inherited from I00-I99, I70
- atheroembolism (I75.-)Inherited from I00-I99, I70
- cerebral atherosclerosis (I67.2)Inherited from I00-I99, I70
- coronary atherosclerosis (I25.1-)Inherited from I00-I99, I70
- mesenteric atherosclerosis (K55.1)Inherited from I00-I99, I70
- precerebral atherosclerosis (I67.2)Inherited from I00-I99, I70
- primary pulmonary atherosclerosis (I27.0)Inherited from I00-I99, I70
Related Codes
Includes
Official- arteriolosclerosisInherited from I70, I70.72
- arterial degenerationInherited from I70, I70.72
- arteriosclerosisInherited from I70, I70.72
- arteriosclerotic vascular diseaseInherited from I70, I70.72
- arteriovascular degenerationInherited from I70, I70.72
- atheromaInherited from I70, I70.72
- endarteritis deformans or obliteransInherited from I70, I70.72
- senile arteritisInherited from I70, I70.72
- senile endarteritisInherited from I70, I70.72
- vascular degenerationInherited from I70, I70.72
- any condition classifiable to I70.71-Inherited from I70, I70.72
- chronic limb-threatening ischemia NOS of other type of bypass graft(s) of the extremitiesInherited from I70, I70.72
- chronic limb-threatening ischemia of other type of bypass graft(s) of the extremities with rest painInherited from I70, I70.72
- critical limb ischemia NOS of other type of bypass graft(s) of the extremitiesInherited from I70, I70.72
- critical limb ischemia of other type of bypass graft(s) of the extremities with rest painInherited from I70, I70.72
Excludes 1
OfficialNo Excludes 1 notes are included in this display for I70.722. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for I70.722. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify:Inherited from I70, I70.7
- exposure to environmental tobacco smoke (Z77.22)Inherited from I70, I70.7
- history of tobacco dependence (Z87.891)Inherited from I70, I70.7
- occupational exposure to environmental tobacco smoke (Z57.31)Inherited from I70, I70.7
- tobacco dependence (F17.-)Inherited from I70, I70.7
- tobacco use (Z72.0)Inherited from I70, I70.7
- code, if applicable, to identify chronic total occlusion of artery of extremity (I70.92)Inherited from I70, I70.7
Code Also
OfficialNo Code Also instructions are included in this display for I70.722. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is I70.722 an HCC code?
Yes. I70.722 (Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg) maps to HCC 264, Vascular Disease with Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.455. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: I70.722 is billable and maps to V28 HCC 264, Vascular Disease with Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- I70.722
- Description
- Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg
- HCC (V28)
- HCC 264 — Vascular Disease with Complications
- RAF reference coefficient
- 0.455
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work I70.722 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for I70.722
For I70.722, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
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What This Code Means
I70.722 is the ICD-10-CM diagnosis code for atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg. Hardening and narrowing of a bypass graft in the left leg causing pain at rest due to poor blood flow. I70.722 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of arteries, arterioles and capillaries (i70-i79).
Under the CMS-HCC V28 risk adjustment model, I70.722 maps to Vascular Disease with Complications (HCC 264) with a source-labeled community, non-dual, aged reference coefficient of 0.455. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Confirm left leg laterality is explicitly documented in the medical record. For I70.722, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I70.722 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm left leg laterality is explicitly documented in the medical record
- •Document the specific bypass graft type to ensure accurate code selection
Clinical Significance
This code captures atherosclerosis affecting other type bypass graft(s) of the extremities with rest pain in the left 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 (left 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 grafts
- •I70.521-I70.529: Atherosclerosis of nonautologous biological bypass graft with rest pain; for cadaveric or bovine grafts
- •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