I70.92

Billable

Chronic total occlusion of artery of the extremities

HCC Category Mapping

V24HCC 108 — Vascular Disease

0.297

ESRDHCC 108 — Vascular Disease

0.000

What This Code Means

Complete blockage of an artery in the arms or legs that has persisted over time, preventing blood flow to the extremity.

Coding Tips

•Confirm documentation states 'chronic total occlusion' or complete blockage that is long-standing
•Specify which extremity is affected; this code may be used with additional codes for specific location

Clinical Significance

Chronic total occlusion of an artery of the extremities indicates complete blockage of a peripheral artery that has developed gradually over time, as opposed to an acute embolic event. This represents severe peripheral arterial disease that may result in critical limb ischemia, and is an important secondary code that adds specificity to the underlying atherosclerotic condition. Capturing this code alongside the primary atherosclerosis code ensures full documentation of disease severity for risk adjustment and care planning.

Documentation Requirements

✓Complete (total) occlusion of a peripheral artery explicitly documented — not just stenosis or partial blockage
✓Chronic nature confirmed — this is not an acute arterial embolism or thrombosis
✓Affected artery identified (e.g., femoral, popliteal, tibial)
✓Imaging or vascular study confirming the total occlusion (angiography, CT angiography, duplex ultrasound)
✓This is a secondary code — assign the underlying atherosclerosis code (I70.-) as the primary diagnosis
✓Laterality documented (captured through the primary atherosclerosis code)

Code First

atherosclerosis of arteries of the extremities (I70.2-, I70.3-, I70.4-, I70.5-, I70.6-, I70.7-)

Commonly Confused Codes

I70.201-I70.299 — Atherosclerosis of native arteries of extremities (the primary condition code; I70.92 is used in addition to specify total occlusion)I74.3/I74.4/I74.5 — Embolism and thrombosis of arteries of lower/upper extremities (acute events, not chronic total occlusion)I70.92 is an additional code — do not use it alone without the underlying atherosclerosis code I25.82 — Chronic total occlusion of coronary artery (coronary, not peripheral — different anatomical location)

Code Hierarchy

└I70Atherosclerosis └I70.9Other and unspecified atherosclerosis └I70.92Chronic total occlusion of artery of the extremities

└I70.92Chronic total occlusion of artery of the extremities