Skip to content
HCC Buddy home

I83.028 ICD-10-CM Code: Varicose veins of left lower extremity with ulcer other part of lower leg

I83.028 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

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

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

I83.028

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

Varicose veins of left lower extremity with ulcer other part of lower leg

Enlarged veins in the left leg with an open sore on another part of the lower leg (such as the shin or upper calf). The ulcer develops due to the varicose veins.

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

RAF 0.646

CMS-HCC V24

HCC 107

RAF 0.383

ACA/HHS

HCC 217

Varies by metal level

ESRD/PACE

HCC 107

RAF 0.144

RXHCC

N/A

—

Not mapped

Code Book Path

Official
I83.0Varicose veins of lower extremities with ulcer
I83.02Varicose veins of left lower extremity with ulcer
I83.028Varicose veins of left lower extremity with ulcer other part of lower leg

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I83.028 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I83.028 in this effective period.

Related Child Codes

Official
I83.021Varicose veins of left lower extremity with ulcer of thigh
I83.022Varicose veins of left lower extremity with ulcer of calf
I83.023Varicose veins of left lower extremity with ulcer of ankle
I83.024Varicose veins of left lower extremity with ulcer of heel and midfoot
I83.025Varicose veins of left lower extremity with ulcer other part of foot

Includes

Official

ICD-10-CM does not list Includes notes for I83.028 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I83.028 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I83.028 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I83.028 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I83.028 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation of varicose veins with active ulceration of the left lower extremity
Specific ulcer location documented (other part of lower leg) — 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 left lower extremity
Specific ulcer location documented (other part of lower leg) — 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 left 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
I83.228 — 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 right 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 I83.028 an HCC code?

Yes. I83.028 (Varicose veins of left lower extremity with ulcer other part of lower leg) 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: I83.028 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
I83.028
Description
Varicose veins of left lower extremity with ulcer other part of lower leg
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 I83.028 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I83.028

For I83.028 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 I83.028 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

I83.028 is the ICD-10-CM diagnosis code for varicose veins of left lower extremity with ulcer other part of lower leg. Enlarged veins in the left leg with an open sore on another part of the lower leg (such as the shin or upper calf). The ulcer develops due to the varicose veins. I83.028 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, I83.028 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, I83.028 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.

This code applies to ulcers on the lower leg excluding the ankle and calf areas that have separate codes. Because I83.028 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 I83.028 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This code applies to ulcers on the lower leg excluding the ankle and calf areas that have separate codes
  • •Ensure documentation clearly identifies the lower leg location to differentiate from ankle or calf ulcers

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 left lower extremity
  • ✓Specific ulcer location documented (other part of lower leg) — 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

  • •I83.228: 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 right 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

Child Codes

I83.021Varicose veins of left lower extremity with ulcer of thigh
HCC 383
I83.022Varicose veins of left lower extremity with ulcer of calf
HCC 383
I83.023Varicose veins of left lower extremity with ulcer of ankle
HCC 383
I83.024Varicose veins of left lower extremity with ulcer of heel and midfoot
HCC 383
I83.025Varicose veins of left lower extremity with ulcer other part of foot
HCC 383
I83.028Varicose veins of left lower extremity with ulcer other part of lower leg
HCC 383
I83.029Varicose veins of left lower extremity with ulcer of unspecified site
HCC 383

Code Hierarchy

└I83Varicose veins of lower extremities└I83.0Varicose veins of lower extremities with ulcer└I83.02Varicose veins of left lower extremity with ulcer└I83.028Varicose veins of left lower extremity with ulcer other part of lower leg
└I83.028Varicose veins of left lower extremity with ulcer other part of lower leg

Because I83.028 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.

I83.028 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. Because I83.028 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work I83.028 in HCC Buddy

Open I83.028 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.

Open in Code BookOpen in EncoderStart Pro