What is ICD-10 code I83.215?

I83.215 is the ICD-10-CM diagnosis code for Varicose veins of right lower extremity with both ulcer other part of foot and inflammation. Enlarged veins in the right lower leg with an open sore on another part of the foot and swelling. I83.215 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I83.215 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. I83.215 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. I83.215 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 I83.215 map to under V28?

I83.215 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 I83.215 pay in RAF?

I83.215 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 I83.215?

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 I83.215, 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.

2026 ICD-10-CM I83.215: Varicose veins

I83.215 maps to CMS-HCC V28 383 (RAF 0.646). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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Code lookupI83.215Effective 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)

I83.215

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

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

Enlarged veins in the right lower leg with an open sore on another part of the foot and swelling.

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

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

I83.2Varicose veins of lower extremities with both ulcer and inflammation

I83.21Varicose veins of right lower extremity with both ulcer and inflammation

I83.215Varicose veins of right lower extremity with both ulcer other part of foot and inflammation

Inclusion Terms

Official

Varicose veins of right lower extremity with both ulcer of toe and inflammation

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I83.215 in this effective period.

Related Child Codes

Official

I83.211Varicose veins of right lower extremity with both ulcer of thigh and inflammation

I83.212Varicose veins of right lower extremity with both ulcer of calf and inflammation

I83.213Varicose veins of right lower extremity with both ulcer of ankle and inflammation

I83.214Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation

I83.218Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation

Includes

Official

ICD-10-CM does not list Includes notes for I83.215 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I83.215 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I83.215 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I83.215 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I83.215 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 foot)

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 foot)

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

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 I83.215 an HCC code?

Yes. I83.215 (Varicose veins of right lower extremity with both ulcer other part of foot and inflammation) 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: I83.215 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: I83.215
Description: Varicose veins of right lower extremity with both ulcer other part of foot and inflammation
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 I83.215 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I83.215

For I83.215 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 I83.215 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I83.215 is the ICD-10-CM diagnosis code for varicose veins of right lower extremity with both ulcer other part of foot and inflammation. Enlarged veins in the right lower leg with an open sore on another part of the foot and swelling. I83.215 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, I83.215 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, I83.215 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.

Use this code for foot ulcers not on the heel or midfoot (e.g., toes, dorsum). Because I83.215 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 I83.215 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code for foot ulcers not on the heel or midfoot (e.g., toes, dorsum)
•Ensure the ulcer location is documented as being on the foot, not the leg

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 foot)
✓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