I83.004

Billable

Varicose veins of unspecified lower extremity with ulcer of heel and midfoot

HCC Category Mapping

V28HCC 383 — Diabetic Skin Ulcer and Severe Skin Conditions

0.517

V24HCC 107 — Vascular Disease with Complications

0.450

ESRDHCC 107 — Vascular Disease with Complications

0.000

What This Code Means

Enlarged, twisted veins in the leg with an open sore or ulcer on the heel or midfoot area caused by poor circulation.

Coding Tips

•Use specifically for heel and midfoot ulcers; other locations require different codes
•Document the extent of ulceration and any signs of infection or delayed healing

Clinical Significance

Varicose veins with ulceration represent a significant complication of chronic venous insufficiency where skin breakdown has occurred due to sustained venous hypertension. These venous ulcers are slow-healing wounds that require ongoing wound care, compression therapy, and monitoring for infection. This diagnosis is a high-impact HCC that reflects the increased resource utilization and clinical complexity of managing chronic venous ulceration.

Documentation Requirements

✓Provider documentation of varicose veins with active ulceration of the unspecified lower extremity
✓Specific ulcer location documented (heel and midfoot) — anatomical site determines code specificity
✓Description of ulcer characteristics: size, depth, wound bed appearance, drainage, and stage if applicable
✓Confirmation that the ulcer is a direct complication of the varicose veins (causal relationship)
✓Current wound care treatment plan and any changes in management
✓Assessment for signs of inflammation, infection, or cellulitis which would require additional or different codes
✓Query provider for laterality (right vs. left) — unspecified codes should only be used as a last resort

Commonly Confused Codes

I83.204 — Varicose veins with BOTH ulcer and inflammation; use when both ulceration and inflammation are documented together L97.x — Non-pressure chronic ulcer of lower limb; use when the ulcer is NOT caused by varicose veins (different etiology)I87.2 — Venous insufficiency (chronic/peripheral); use when there is venous insufficiency without varicose veins or ulceration L89.x — Pressure ulcer codes; distinguish from venous stasis ulcers which are caused by varicose veins, not prolonged pressure

Code Hierarchy

└I83Varicose veins of lower extremities └I83.0Varicose veins of lower extremities with ulcer └I83.00Varicose veins of unspecified lower extremity with ulcer └I83.004Varicose veins of unspecified lower extremity with ulcer of heel and midfoot

└I83.004Varicose veins of unspecified lower extremity with ulcer of heel and midfoot