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ICD-10/I70.238

I70.238 ICD-10-CM Code: Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 299 — PERIPHERAL VASCULAR DISORDERS WITH MCC (MDC 05)
  • MS-DRG 300 — PERIPHERAL VASCULAR DISORDERS WITH CC (MDC 05)
  • MS-DRG 301 — PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC (MDC 05)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 263 — Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene (supersedes HCC 264, HCC 383, HCC 409)
  • HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

Other models: CMS-HCC V22 HCC 106 · CMS-HCC V22 HCC 161 · RxHCC V08 HCC 311

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg is a billable ICD-10-CM diagnosis code (I70.238).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for I70.238 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • any condition classifiable to I70.211 and I70.221
  • chronic limb-threatening ischemia of native arteries of right leg with ulceration
  • critical limb ischemia of native arteries of right leg with ulceration
  • arteriolosclerosis
  • arterial degeneration
  • arteriosclerosis
  • arteriosclerotic vascular disease
  • arteriovascular degeneration
  • atheroma
  • endarteritis deformans or obliterans
  • senile arteritis
  • senile endarteritis
  • vascular degeneration

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify severity of ulcer (L97.-)
  • Use additional code, if applicable, to identify chronic total occlusion of artery of extremity (I70.92)
  • Use additional code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Change history

  • FY2020 — 2019-10-01
    Description revised
    Atherosclerosis of native arteries of right leg with ulceration of other part of lower right leg → Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
    FY2020 changes
  • FY2020 — 2019-10-01
    Short description revised
    Athscl natv art of right leg w ulcer oth prt lower right leg → Athscl native art of right leg with ulcer oth prt low leg
    FY2020 changes

Verify Before Coding

  • Billable — reportable as written.
  • Age-restricted: the Medicare Code Editor lists this as a adult (age 15-124) diagnosis; other ages are presumed incorrect.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of I70.238 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99) [Hierarchy]
  • I70-I79 — Diseases of arteries, arterioles and capillaries [Hierarchy]

Referenced by Excludes1 notes

  • I73.9 — Peripheral vascular disease, unspecified [Excludes1](via I70.2.-): “atherosclerosis of the extremities (I70.2--I70.7-)” · check together
  • I77.6 — Arteritis, unspecified [Excludes1](via I70.-): “deformans (I70.-)” · check together

Referenced by Code First instructions

  • I70.92 — Chronic total occlusion of artery of the extremities [Code First](via I70.2.-): “atherosclerosis of arteries of the extremities (I70.2-, I70.3-, I70.4-, I70.5-, I70.6-, I70.7-)” · check together
  • L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified [Code First](via I70.23.-): “atherosclerosis of the lower extremities (I70.23-, I70.24-, I70.33-, I70.34-, I70.43-, I70.44-, I70.53-, I70.54-, I70.63-, I70.64-, I70.73-, I70.74-)” · check together

Clinical classification (CCSR)

  • CIR026 — Peripheral and visceral vascular disease [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 263 — Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene [CMS-HCC]: “Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene — supersedes HCC 264 (Vascular Disease with Complications), HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle), HCC 409 (Amputation Status, Lower Limb/Amputation Complications)”
  • HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle [CMS-HCC]

Potential MS-DRG

  • DRG 299 — PERIPHERAL VASCULAR DISORDERS WITH MCC [MS-DRG]: “PERIPHERAL VASCULAR DISORDERS WITH MCC (MDC 05)”
  • DRG 300 — PERIPHERAL VASCULAR DISORDERS WITH CC [MS-DRG]: “PERIPHERAL VASCULAR DISORDERS WITH CC (MDC 05)”
  • DRG 301 — PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC [MS-DRG]: “PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC (MDC 05)”

MDC crossing · procedures (17209)

  • MDC 05 — Diseases and Disorders of the Circulatory System [MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 00HE0MZ — Insertion of Neurostimulator Lead into Cranial Nerve, Open Approach [Same-MDC procedure]: “Insertion of Neurostimulator Lead into Cranial Nerve, Open Approach — grouped in MDC 05, the procedure side of this code's crossing.” · check together
  • 00HE3MZ — Insertion of Neurostimulator Lead into Cranial Nerve, Percutaneous Approach [Same-MDC procedure]: “Insertion of Neurostimulator Lead into Cranial Nerve, Percutaneous Approach — grouped in MDC 05, the procedure side of this code's crossing.” · check together
  • 00HE4MZ — Insertion of Neurostimulator Lead into Cranial Nerve, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Neurostimulator Lead into Cranial Nerve, Percutaneous Endoscopic Approach — grouped in MDC 05, the procedure side of this code's crossing.” · check together
  • 015K0ZZ — Destruction of Head and Neck Sympathetic Nerve, Open Approach [Same-MDC procedure]: “Destruction of Head and Neck Sympathetic Nerve, Open Approach — grouped in MDC 05, the procedure side of this code's crossing.” · check together
  • 015K3ZZ — Destruction of Head and Neck Sympathetic Nerve, Percutaneous Approach [Same-MDC procedure]: “Destruction of Head and Neck Sympathetic Nerve, Percutaneous Approach — grouped in MDC 05, the procedure side of this code's crossing.” · check together
  • and 17204 more

Index entries

  • Arteriosclerosis, arteriosclerotic (diffuse) (obliterans) (of) (senile) (with calcification), extremities (native arteries), leg, right, with, ulceration (and intermittent claudication and rest pain), lower leg NEC[Index term]

Nearest codes (40)

  • I70 — Atherosclerosis [Sibling]
  • I70.208 — Unspecified atherosclerosis of native arteries of extremities, other extremity [Sibling]
  • I70.209 — Unspecified atherosclerosis of native arteries of extremities, unspecified extremity [Sibling]
  • I70.21 — Atherosclerosis of native arteries of extremities with intermittent claudication [Sibling]
  • I70.211 — Atherosclerosis of native arteries of extremities with intermittent claudication, right leg [Sibling]
  • I70.212 — Atherosclerosis of native arteries of extremities with intermittent claudication, left leg [Sibling]
  • I70.213 — Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs [Sibling]
  • I70.218 — Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity [Sibling]
  • and 32 more

Change history (2)

  • FY2020 — Description revised [Change history]
  • and 1 more

Referenced by Other Codes

Clinical classification (AHRQ CCSR):CIR026 — Peripheral and visceral vascular disease (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 3 MS-DRGs: DRG 299 (MDC 05), DRG 300 (MDC 05), DRG 301 (MDC 05).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name I70.238 or its code family.

2 Excludes1 notes: I73.9 (via I70.2.-), I77.6 (via I70.-).

2 Code First instructions across 2 chapters: I70.92 (via I70.2.-), L97 (via I70.23.-).

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I70.238 in its code family, with their registry titles.

  • I70.231 — Atherosclerosis of native arteries of right leg with ulceration of thigh
  • I70.232 — Atherosclerosis of native arteries of right leg with ulceration of calf
  • I70.233 — Atherosclerosis of native arteries of right leg with ulceration of ankle
  • I70.234 — Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot
  • I70.235 — Atherosclerosis of native arteries of right leg with ulceration of other part of foot
  • I70.239 — Atherosclerosis of native arteries of right leg with ulceration of unspecified site
  • I70.24 — Atherosclerosis of native arteries of left leg with ulceration
  • I70.241 — Atherosclerosis of native arteries of left leg with ulceration of thigh
  • I70.242 — Atherosclerosis of native arteries of left leg with ulceration of calf
  • I70.243 — Atherosclerosis of native arteries of left leg with ulceration of ankle

View all codes in the I70 family

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Arteriosclerosis, arteriosclerotic (diffuse) (obliterans) (of) (senile) (with calcification), extremities (native arteries), leg, right, with, ulceration (and intermittent claudication and rest pain), lower leg NEC