I83.223 ICD-10-CM Code: Varicose veins of left lower extremity with both ulcer of ankle and inflammation
I83.223 maps to CMS-HCC V28 383. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)
I83.223
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceVaricose veins of left lower extremity with both ulcer of ankle and inflammation
Enlarged, twisted veins in the left leg with an open sore on the ankle and swelling caused by poor blood circulation.
Buddy Insight
Varicose veins with both ulceration and inflammation represent advanced chronic venous insufficiency requiring ongoing wound management and vascular monitoring.
CMS-HCC V28
MappedHCC 383
Coefficient HCC 383: 0.646 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
Context neededHCC 217
Coefficient needs member context
ESRD/PACE
Context neededHCC 107
Coefficient needs member context
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for I83.223. Check the code and parent instructions in the Code Book.
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from I00-I99, I83
- certain infectious and parasitic diseases (A00-B99)Inherited from I00-I99, I83
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from I00-I99, I83
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from I00-I99, I83
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from I00-I99, I83
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from I00-I99, I83
- neoplasms (C00-D49)Inherited from I00-I99, I83
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from I00-I99, I83
- systemic connective tissue disorders (M30-M36)Inherited from I00-I99, I83
- transient cerebral ischemic attacks and related syndromes (G45.-)Inherited from I00-I99, I83
- varicose veins complicating pregnancy (O22.0-)Inherited from I00-I99, I83
- varicose veins complicating the puerperium (O87.4)Inherited from I00-I99, I83
Related Codes
Includes
OfficialNo Includes notes are included in this display for I83.223. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for I83.223. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for I83.223. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify severity of ulcer (L97.-)Inherited from I83.2
Code Also
OfficialNo Code Also instructions are included in this display for I83.223. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 I83.223 an HCC code?
Yes. I83.223 (Varicose veins of left lower extremity with both ulcer of ankle and inflammation) maps to HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.646. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: I83.223 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
- I83.223
- Description
- Varicose veins of left lower extremity with both ulcer of ankle and inflammation
- HCC (V28)
- HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
- RAF reference coefficient
- 0.646
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work I83.223 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for I83.223
For I83.223, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
I83.223 is the ICD-10-CM diagnosis code for varicose veins of left lower extremity with both ulcer of ankle and inflammation. Enlarged, twisted veins in the left leg with an open sore on the ankle and swelling caused by poor blood circulation. I83.223 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, I83.223 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle (HCC 383) with a source-labeled community, non-dual, aged reference coefficient of 0.646. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Use I83.223 when the provider wording supports varicose veins of left lower extremity with both ulcer of ankle and inflammation. Check the FY2026 tabular notes and the full code path before the final code choice. For I83.223, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for I83.223 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use I83.223 when the provider wording supports varicose veins of left lower extremity with both ulcer of ankle and inflammation. Check the FY2026 tabular notes and the full code path before the final code choice.
- •For this DOS, capture the provider's current assessment and the care action documented for varicose veins of left lower extremity with both ulcer of ankle and inflammation. Keep the checklist tied to the note.
- •Do not swap I83.223 with I83.221. The FY2026 tabular describes I83.221 as varicose veins of left lower extremity with both ulcer of thigh and inflammation. Follow the documented detail.
- •The FY2026 Alphabetic Index routes Varix (lower limb) under leg (asymptomatic) > left (asymptomatic) with ulcer > ankle > with inflammation to I83.223. Confirm that the indexed wording matches the provider documentation before using this route.
- •Ask Buddy to show the official notes for I83.223 or compare its code path with I83.221.
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 (ankle)
- ✓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