What is ICD-10 code I83.019?

I83.019 is the ICD-10-CM diagnosis code for Varicose veins of right lower extremity with ulcer of unspecified site. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I83.019 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I83.019 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. I83.019 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. I83.019 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 I83.019 map to under V28?

I83.019 maps to CMS-HCC V28 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does I83.019 pay in RAF?

I83.019 carries a community, non-dual, aged (CNA) RAF weight of 0.646 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for I83.019?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For I83.019, V28 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle at RAF 0.646 while V24 mapped to Vascular Disease with Complications at RAF 0.383. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports I83.019?

Query the provider if the ulcer location is documented elsewhere in the medical record (such as ankle, calf, or thigh), as more specific codes (I83.011-I83.018) provide better clinical detail and may affect reimbursement Ensure the documentation clearly links the ulcer to the varicose veins of the right lower extremity; if the ulcer is on the left leg or bilateral, use different codes accordingly Because I83.019 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM I83.019: Varicose veins

I83.019 maps to CMS-HCC V28 383 (RAF 0.646). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupI83.019Effective 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)

I83.019

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

Varicose veins of right lower extremity with ulcer of unspecified site

This code describes enlarged, twisted veins in the right leg that have developed an open sore or wound, but the specific location of the ulcer on the leg is not documented. Varicose veins occur when veins become weakened and blood pools, which can lead to skin breakdown and ulceration.

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

Mapped

HCC 383

Chronic Ulcer of Skin, Except...

RAF 0.646

CMS-HCC V24

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.383

ACA/HHS

Mapped

HCC 217

HHS-HCC 217

Varies by metal level

ESRD/PACE

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.144

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

I83.019Varicose veins of right lower extremity with ulcer of unspecified site

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I83.019 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I83.019 in this effective period.

Related Child Codes

Official

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

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

Includes

Official

ICD-10-CM does not list Includes notes for I83.019 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I83.019 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I83.019 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I83.019 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I83.019 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

Specific ulcer location documented (unspecified site) — 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 (unspecified site) — 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

I83.219 — 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 I83.019 an HCC code?

Yes. I83.019 (Varicose veins of right lower extremity with ulcer of unspecified site) maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle under the CMS-HCC V28 risk adjustment model (and Vascular Disease with Complications under V24), with a community non-dual aged RAF of 0.646. It is billable for payment year 2026.

Coder answer: I83.019 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: I83.019
Description: Varicose veins of right lower extremity with ulcer of unspecified site
HCC (V28): HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
RAF: 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

V24HCC 107, Vascular Disease with Complications

0.383

ESRDHCC 107, Vascular Disease with Complications

0.144

Each model's RAF is its CMS base weight for that model's standard population, so 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 segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work I83.019 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I83.019

For I83.019 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 I83.019 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I83.019 is the ICD-10-CM diagnosis code for varicose veins of right lower extremity with ulcer of unspecified site. This code describes enlarged, twisted veins in the right leg that have developed an open sore or wound, but the specific location of the ulcer on the leg is not documented. Varicose veins occur when veins become weakened and blood pools, which can lead to skin breakdown and ulceration. I83.019 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, I83.019 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle (HCC 383) with a community, non-dual, aged base RAF weight of 0.646. Under the older CMS-HCC V24 model, I83.019 maps to Vascular Disease with Complications (HCC 107) with a community, non-dual, aged base RAF weight of 0.383. 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.

Query the provider if the ulcer location is documented elsewhere in the medical record (such as ankle, calf, or thigh), as more specific codes (I83.011-I83.018) provide better clinical detail and may affect reimbursement. Because I83.019 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for I83.019 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Query the provider if the ulcer location is documented elsewhere in the medical record (such as ankle, calf, or thigh), as more specific codes (I83.011-I83.018) provide better clinical detail and may affect reimbursement
•Ensure the documentation clearly links the ulcer to the varicose veins of the right lower extremity; if the ulcer is on the left leg or bilateral, use different codes accordingly

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 (unspecified site) — 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

•I83.219: 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