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I83.208 ICD-10-CM Code: Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation

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)

I83.208

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

Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation

Enlarged veins in the lower leg with an open sore on another part of the lower leg and swelling, affecting an unspecified leg.

Buddy the Bee presenting code insight

Buddy Insight

Varicose veins with both ulceration and inflammation represent advanced chronic venous insufficiency requiring ongoing wound management and vascular monitoring.

CMS-HCC V28

HCC 383

RAF 0.517

CMS-HCC V24

HCC 107

RAF 0.450

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 107

RAF 0.0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
I83.2Varicose veins of lower extremities with both ulcer and inflammation
I83.20Varicose veins of unspecified lower extremity with both ulcer and inflammation
I83.208Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I83.208 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I83.208 in this effective period.

Related Child Codes

Official
I83.201Varicose veins of unspecified lower extremity with both ulcer of thigh and inflammation
I83.202Varicose veins of unspecified lower extremity with both ulcer of calf and inflammation
I83.203Varicose veins of unspecified lower extremity with both ulcer of ankle and inflammation
I83.204Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation
I83.205Varicose veins of unspecified lower extremity with both ulcer other part of foot and inflammation

Includes

Official

ICD-10-CM does not list Includes notes for I83.208 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I83.208 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I83.208 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I83.208 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I83.208 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documented diagnosis of varicose veins of the lower extremity
Laterality clearly specified (left lower extremity)
Ulcer location documented (other part of lower extremity)
Presence of BOTH ulceration AND inflammation explicitly stated

MEAT Support

HCC Buddy guidance
Documented diagnosis of varicose veins of the lower extremity
Laterality clearly specified (left lower extremity)
Ulcer location documented (other part of lower extremity)
Presence of BOTH ulceration AND inflammation explicitly stated

Audit Caution

HCC Buddy guidance
Coding ulcer without documented inflammation — the I83.2xx series requires BOTH ulcer AND inflammation to be present; if only one is documented, use I83.0xx (ulcer only) or I83.1xx (inflammation only)
Failing to verify laterality — always confirm right, left, bilateral, or unspecified from the clinical documentation before selecting the 4th character
Not querying for specific ulcer site — using an unspecified site code (x9) when provider documentation elsewhere describes the exact anatomical location
Confusing varicose vein ulcers with pressure ulcers (L89.xxx) or diabetic foot ulcers (E11.621) which have entirely different code categories

Common Mistakes

HCC Buddy guidance
I83.21x — Right lower extremity varicose veins with ulcer and inflammation; laterality must match documented side
I83.219 or I83.229 — Unspecified ulcer site; use only when the anatomical location of the ulcer cannot be determined
I83.0xx — Varicose veins with ulcer only, without inflammation; requires both ulcer AND inflammation for the I83.2xx series
I83.1xx — Varicose veins with inflammation only, without ulcer; if no ulcer is documented, use this category instead

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is I83.208 an HCC code?

Yes. I83.208 maps to Diabetic Skin Ulcer and Severe Skin Conditions under the CMS-HCC V28 risk adjustment model (and Vascular Disease with Complications under V24).

HCC Category Mapping

V28HCC 383, Diabetic Skin Ulcer and Severe Skin Conditions
0.517
V24HCC 107, Vascular Disease with Complications
0.450
ESRDHCC 107, Vascular Disease with Complications
0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.

MEAT Criteria for I83.208

For I83.208to 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 I83.208 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

I83.208 is the ICD-10-CM diagnosis code for varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation. Enlarged veins in the lower leg with an open sore on another part of the lower leg and swelling, affecting an unspecified leg. I83.208 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, I83.208 maps to Diabetic Skin Ulcer and Severe Skin Conditions (HCC 383) with a community, non-dual, aged base RAF weight of 0.517. Under the older CMS-HCC V24 model, I83.208 maps to Vascular Disease with Complications (HCC 107) with a community, non-dual, aged base RAF weight of 0.450. 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.

Document the specific anatomical location of the ulcer (e.g., shin, knee area) for proper code selection. Because I83.208 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 I83.208 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document the specific anatomical location of the ulcer (e.g., shin, knee area) for proper code selection
  • Ensure both the varicose veins and inflammatory component are clearly documented

Clinical Significance

Varicose veins with both ulceration and inflammation represent advanced chronic venous insufficiency requiring ongoing wound management and vascular monitoring. The combination of ulceration and inflammation indicates significant tissue compromise from chronic venous hypertension, increasing the risk of infection, cellulitis, and delayed wound healing. This diagnosis signals the need for compression therapy, wound care, and potential surgical intervention to prevent further deterioration.

Documentation Requirements

  • Documented diagnosis of varicose veins of the lower extremity
  • Laterality clearly specified (left lower extremity)
  • Ulcer location documented (other part of lower extremity)
  • Presence of BOTH ulceration AND inflammation explicitly stated
  • Description of ulcer characteristics (size, depth, drainage, wound bed)
  • Signs of inflammation documented (erythema, warmth, edema, tenderness)
  • Current treatment plan for wound management and venous insufficiency
  • Assessment of whether condition is new, worsening, or stable

Commonly Confused Codes

  • I83.21x: Right lower extremity varicose veins with ulcer and inflammation; laterality must match documented side
  • I83.219 or I83.229: Unspecified ulcer site; use only when the anatomical location of the ulcer cannot be determined
  • I83.0xx: Varicose veins with ulcer only, without inflammation; requires both ulcer AND inflammation for the I83.2xx series
  • I83.1xx: Varicose veins with inflammation only, without ulcer; if no ulcer is documented, use this category instead
  • L97.xxx: Non-pressure chronic ulcer of lower limb; use when the ulcer is not attributable to varicose veins

Child Codes

Code Hierarchy

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