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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

ICD-10-CM Code View

HCC Buddy Code Card

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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 guidance

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.

Buddy the Bee presenting code insight

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

HCC 383

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

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

Official
I83.0Varicose veins of lower extremities with ulcer
I83.00Varicose veins of unspecified lower extremity with ulcer
I83.005Varicose veins of unspecified lower extremity with ulcer other part of foot

Inclusion Terms

Official
  • Varicose veins of unspecified lower extremity with ulcer of toe

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I83.005 in this effective period.

Related Child Codes

Official
I83.001Varicose veins of unspecified lower extremity with ulcer of thigh
I83.002Varicose veins of unspecified lower extremity with ulcer of calf
I83.003Varicose veins of unspecified lower extremity with ulcer of ankle
I83.004Varicose veins of unspecified lower extremity with ulcer of heel and midfoot
I83.008Varicose veins of unspecified lower extremity with ulcer other part of lower leg

Includes

Official

ICD-10-CM does not list Includes notes for I83.005 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I83.005 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I83.005 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I83.005 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I83.005 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
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)

MEAT Support

HCC Buddy guidance
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)

Audit Caution

HCC Buddy guidance
Coding the ulcer location incorrectly — the 6th character specifies the anatomical site (thigh, calf, ankle, heel/midfoot, other foot, other lower leg) and must match documentation exactly
Using an unspecified laterality code when the affected side is documented — always capture the specific side
Missing concurrent inflammation that would warrant using the combined ulcer-and-inflammation code (I83.2xx) instead of the ulcer-only code
Failing to assign an additional code for ulcer severity/stage when applicable per coding guidelines

Common Mistakes

HCC Buddy guidance
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

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

V28HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
0.646

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

Child Codes

Code Hierarchy

Because I83.005 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

I83.005 maps to CMS-HCC V28 category 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for I83.005. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work I83.005 in HCC Buddy

Open I83.005 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.