What is ICD-10 code I83.011?

I83.011 is the ICD-10-CM diagnosis code for Varicose veins of right lower extremity with ulcer of thigh. Enlarged, twisted veins in the right leg with an open sore on the thigh. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I83.011 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I83.011 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I83.011 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I83.011 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does I83.011 map to under V28?

I83.011 maps to CMS-HCC V28 HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM I83.011: Varicose veins of right

I83.011 maps to CMS-HCC V28 383. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupI83.011

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)

I83.011

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Varicose veins of right lower extremity with ulcer of thigh

Enlarged, twisted veins in the right leg with an open sore on the thigh.

Buddy Insight

Varicose veins with ulceration represent a significant complication of chronic venous insufficiency where skin breakdown has occurred due to sustained venous hypertension.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 383

Chronic Ulcer of Skin, Except...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I83.0Varicose veins of lower extremities with ulcer I83.01Varicose veins of right lower extremity with ulcer I83.011Varicose veins of right lower extremity with ulcer of thigh

Inclusion Terms

Official

No inclusion terms are included in this display for I83.011. 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, I83
certain infectious and parasitic diseases (A00-B99)Inherited from I00-I99, I83
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from I00-I99, I83
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from I00-I99, I83
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from I00-I99, I83
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from I00-I99, I83
neoplasms (C00-D49)Inherited from I00-I99, I83
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from I00-I99, I83
systemic connective tissue disorders (M30-M36)Inherited from I00-I99, I83
transient cerebral ischemic attacks and related syndromes (G45.-)Inherited from I00-I99, I83
varicose veins complicating pregnancy (O22.0-)Inherited from I00-I99, I83
varicose veins complicating the puerperium (O87.4)Inherited from I00-I99, I83

Related Codes

Official

I83.012Varicose veins of right lower extremity with ulcer of calf I83.013Varicose veins of right lower extremity with ulcer of ankle I83.014Varicose veins of right lower extremity with ulcer of heel and midfoot I83.015Varicose veins of right lower extremity with ulcer other part of foot I83.018Varicose veins of right lower extremity with ulcer other part of lower leg

Includes

Official

No Includes notes are included in this display for I83.011. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for I83.011. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for I83.011. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify severity of ulcer (L97.-)Inherited from I83.0

Code Also

Official

No Code Also instructions are included in this display for I83.011. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of varicose veins with active ulceration of the right lower extremity

Specific ulcer location documented (thigh) — 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 right lower extremity

Specific ulcer location documented (thigh) — 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 right 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

I83.211 — 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

Verify laterality carefully — do not confuse with left lower extremity codes which have different 5th/6th characters

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 I83.011 an HCC code?

Yes. I83.011 (Varicose veins of right lower extremity with ulcer of thigh) 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: I83.011 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: I83.011
Description: Varicose veins of right lower extremity with ulcer of thigh
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 I83.011 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for I83.011

For I83.011, 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

I83.011 is the ICD-10-CM diagnosis code for varicose veins of right lower extremity with ulcer of thigh. Enlarged, twisted veins in the right leg with an open sore on the thigh. I83.011 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, I83.011 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 I83.011; use the applicable model and payment year when reviewing the V28 mapping. 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 documentation explicitly states 'right' leg and ulcer is on the thigh. For I83.011, 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 I83.011 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm documentation explicitly states 'right' leg and ulcer is on the thigh
•Differentiate from other leg locations (calf, ankle, foot) which have different codes

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 right lower extremity
✓Specific ulcer location documented (thigh) — 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

Commonly Confused Codes

•I83.211: 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
•Verify laterality carefully: do not confuse with left lower extremity codes which have different 5th/6th characters
•L89.x: Pressure ulcer codes; distinguish from venous stasis ulcers which are caused by varicose veins, not prolonged pressure