What is ICD-10 code I83.209?

I83.209 is the ICD-10-CM diagnosis code for Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation. Enlarged veins in the lower leg with an open sore at an unspecified location and swelling, affecting an unspecified leg. I83.209 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I83.209 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. I83.209 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. I83.209 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.

What is the V28 vs V24 difference for I83.209?

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 I83.209, V28 maps to Diabetic Skin Ulcer and Severe Skin Conditions at RAF 0.517 while V24 mapped to Vascular Disease with Complications at RAF 0.450. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting I83.209?

Use this code only when the ulcer location cannot be determined from documentation Query the provider if possible to obtain more specific ulcer location for more precise coding Because I83.209 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.

I83.209 ICD-10 Code: Varicose veins of unspecified

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.

Code lookupI83.209Effective 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)

I83.209

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

Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation

Enlarged veins in the lower leg with an open sore at an unspecified location and swelling, affecting an unspecified leg.

Buddy Insight

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

CMS-HCC V28

Mapped

HCC 383

Diabetic Skin Ulcer and Sever...

RAF 0.517

CMS-HCC V24

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.450

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

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

I83.209Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I83.209 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I83.209 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 I83.209 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I83.209 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I83.209 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I83.209 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I83.209 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 (unspecified site)

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 (unspecified site)

Presence of BOTH ulceration AND inflammation explicitly stated

Audit Caution

HCC Buddy guidance

Defaulting to unspecified site when the ulcer location is actually documented elsewhere in the record — always review the entire note before selecting the unspecified code

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

Common Mistakes

HCC Buddy guidance

I83.21x — Right lower extremity varicose veins with ulcer and inflammation; laterality must match documented side

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

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 I83.209 an HCC code?

Yes. I83.209 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 I83.209

For I83.209to 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 I83.209 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

I83.209 is the ICD-10-CM diagnosis code for varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation. Enlarged veins in the lower leg with an open sore at an unspecified location and swelling, affecting an unspecified leg. I83.209 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, I83.209 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, I83.209 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.

Use this code only when the ulcer location cannot be determined from documentation. Because I83.209 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 I83.209 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the ulcer location cannot be determined from documentation
•Query the provider if possible to obtain more specific ulcer location for more precise coding

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 (unspecified site)
✓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
•I83.0xx: 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