What is ICD-10 code I87.313?

I87.313 is the ICD-10-CM diagnosis code for Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity. A chronic condition where high pressure in the veins of both legs causes skin ulcers due to poor circulation, with no identifiable underlying cause. I87.313 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I87.313 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. I87.313 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. I87.313 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 I87.313 map to under V28?

I87.313 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 I87.313 pay in RAF?

I87.313 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 I87.313?

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 I87.313, 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.

What documentation supports I87.313?

Verify documentation specifies bilateral involvement; if only one leg is affected, use a more specific code Ensure ulcer severity and stage are documented separately if required by your facility's coding standards Because I87.313 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. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM I87.313: Chronic venous

I87.313 maps to CMS-HCC V28 383 (RAF 0.646). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

ICD-10-CM Code View

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

Code lookupI87.313Effective 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)

I87.313

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

Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity

A chronic condition where high pressure in the veins of both legs causes skin ulcers due to poor circulation, with no identifiable underlying cause.

Buddy Insight

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

I87.3Chronic venous hypertension (idiopathic)

I87.31Chronic venous hypertension (idiopathic) with ulcer

I87.313Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I87.313 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I87.313 in this effective period.

Related Child Codes

Official

I87.311Chronic venous hypertension (idiopathic) with ulcer of right lower extremity

I87.312Chronic venous hypertension (idiopathic) with ulcer of left lower extremity

I87.319Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity

Includes

Official

ICD-10-CM does not list Includes notes for I87.313 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I87.313 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I87.313 in this effective period.

Use Additional

Official

code to specify site and severity of ulcer (L97.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for I87.313 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Diagnosis of chronic venous hypertension documented

Idiopathic etiology specified (no identifiable secondary cause)

Laterality documented (bilateral lower extremity)

Ulcer presence and characteristics described (size, location, depth, wound bed)

MEAT Support

HCC Buddy guidance

Diagnosis of chronic venous hypertension documented

Idiopathic etiology specified (no identifiable secondary cause)

Laterality documented (bilateral lower extremity)

Ulcer presence and characteristics described (size, location, depth, wound bed)

Audit Caution

HCC Buddy guidance

Using idiopathic venous hypertension codes when there is a documented secondary cause (prior deep vein thrombosis, compression, etc.)

Failing to code the ulcer and inflammation combination (I87.33x) when both components are present

Confusing chronic venous hypertension ulcers with arterial ulcers — arterial insufficiency ulcers are coded differently under I70.x or I73.x

Not specifying laterality when documentation clearly identifies the affected extremity

Common Mistakes

HCC Buddy guidance

I87.311/I87.312 — Unilateral codes; use bilateral only when both legs are affected

I87.33x — Chronic venous hypertension with ulcer AND inflammation; use when both ulcer and inflammation are documented

I87.01x — Postthrombotic syndrome with ulcer; use when the venous hypertension is secondary to prior deep vein thrombosis

I83.0xx — Varicose veins with ulcer; different underlying pathology, use when ulcer is specifically attributed to varicose veins

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 I87.313 an HCC code?

Yes. I87.313 (Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity) 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: I87.313 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: I87.313
Description: Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity
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 I87.313 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I87.313

For I87.313 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 I87.313 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I87.313 is the ICD-10-CM diagnosis code for chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity. A chronic condition where high pressure in the veins of both legs causes skin ulcers due to poor circulation, with no identifiable underlying cause. I87.313 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, I87.313 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, I87.313 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.

Verify documentation specifies bilateral involvement; if only one leg is affected, use a more specific code. Because I87.313 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 I87.313 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation specifies bilateral involvement; if only one leg is affected, use a more specific code
•Ensure ulcer severity and stage are documented separately if required by your facility's coding standards

Clinical Significance

Chronic venous hypertension (idiopathic) with ulcer of the bilateral lower extremity indicates sustained elevated venous pressure without an identifiable secondary cause, resulting in skin breakdown and chronic ulceration. This condition reflects significant chronic vascular disease requiring ongoing wound care, compression therapy, and monitoring for progression. The ulceration component substantially increases infection risk, hospitalization rates, and overall healthcare resource consumption.

Documentation Requirements

✓Diagnosis of chronic venous hypertension documented
✓Idiopathic etiology specified (no identifiable secondary cause)
✓Laterality documented (bilateral lower extremity)
✓Ulcer presence and characteristics described (size, location, depth, wound bed)
✓Evidence of chronic venous insufficiency (edema, skin changes, hemosiderin staining)
✓Current wound management and compression therapy plan
✓Exclusion of secondary causes documented if applicable

Commonly Confused Codes

•I87.311/I87.312: Unilateral codes; use bilateral only when both legs are affected
•I87.33x: Chronic venous hypertension with ulcer AND inflammation; use when both ulcer and inflammation are documented
•I87.01x: Postthrombotic syndrome with ulcer; use when the venous hypertension is secondary to prior deep vein thrombosis
•I83.0xx: Varicose veins with ulcer; different underlying pathology, use when ulcer is specifically attributed to varicose veins
•L97.xxx: Non-pressure chronic ulcer of lower limb; use when the ulcer is not attributable to venous hypertension