I83.005 ICD-10-CM Code: Varicose veins of unspecified lower extremity with ulcer other part of foot
I83.005 maps to CMS-HCC V28 383. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)
I83.005
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceVaricose veins of unspecified lower extremity with ulcer other part of foot
Enlarged, twisted veins in the leg with an open sore on the foot, affecting an unspecified leg.

Buddy Insight
Varicose veins with ulceration represent a significant complication of chronic venous insufficiency where skin breakdown has occurred due to sustained venous hypertension.
CMS-HCC V28
MappedHCC 383
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Varicose veins of unspecified lower extremity with ulcer of toe
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I83.005 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I83.005 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for I83.005 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I83.005 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I83.005 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I83.005 in this effective period.
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 I83.005 an HCC code?
Yes. I83.005 (Varicose veins of unspecified lower extremity with ulcer other part of foot) maps to HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.646. 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: I83.005 is billable and maps to V28 HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- I83.005
- Description
- Varicose veins of unspecified lower extremity with ulcer other part of foot
- HCC (V28)
- HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
- RAF reference coefficient
- 0.646
- 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 I83.005 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT Criteria for I83.005
For I83.005 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I83.005 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I83.005 is the ICD-10-CM diagnosis code for varicose veins of unspecified lower extremity with ulcer other part of foot. Enlarged, twisted veins in the leg with an open sore on the foot, affecting an unspecified leg. I83.005 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (i80-i89).
Under the CMS-HCC V28 risk adjustment model, I83.005 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle (HCC 383) with a source-labeled community, non-dual, aged reference coefficient of 0.646. No V24 mapping is shown for I83.005; use the applicable model and payment year when reviewing the V28 mapping. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. 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.
Verify documentation specifies the foot location and confirm the ulcer is related to the varicose veins. Because I83.005 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 I83.005 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies the foot location and confirm the ulcer is related to the varicose veins
- •Use this code only when the specific leg (right/left) is not documented
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 (other part of foot) — 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
- •I83.205: 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

