I70.469 — Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity
Is I70.469 billable?
Yes, but I70.469 will trip a Medicare edit. I70.469 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists I70.469 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
More specific alternatives
- I70.461Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg
- I70.462Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, left leg
- I70.463Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, bilateral legs
- I70.468Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity
I70.469 at a glance
| Code | I70.469 |
|---|---|
| Description | Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, unspecified extremity |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to I70.469?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name I70.469 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does I70.469 group to?
I70.469 sits in MDC 05 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 299Peripheral Vascular Disorders with MCCmedical
- 300Peripheral Vascular Disorders with CCmedical
- 301Peripheral Vascular Disorders without CC/MCCmedical
As a secondary diagnosis, I70.469 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I70.469 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to I70.469. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Arteriosclerosis, arteriosclerotic › extremities › bypass graft › autologous vein graft › leg › with › gangrene (diffuse) (obliterans) (of) (senile) (with calcification)
- Arteriosclerosis, arteriosclerotic › with › critical limb ischemia › bypass graft › autologous vein graft › leg › with › gangrene (diffuse) (obliterans) (of) (senile) (with calcification)
Use additional code — inherited from I70
Report an additional code alongside I70.469 to fully describe the condition. I70.469 is sequenced first.
Use additional code — inherited from I70.4
Report an additional code alongside I70.469 to fully describe the condition. I70.469 is sequenced first.
- code, if applicable, to identify chronic total occlusion of artery of extremity (I70.92)
Use additional code — inherited from I70.46
Report an additional code alongside I70.469 to fully describe the condition. I70.469 is sequenced first.
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I70.469, but a patient may have both at the same time. When documentation supports it, I70.469 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
Excludes2 — not included here — inherited from I70
The conditions below are not part of I70.469, but a patient may have both at the same time. When documentation supports it, I70.469 and the excluded code may both be reported.
How long has I70.469 existed?
I70.469 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the I70.46 family? (4)
- I70.461Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, right leg
- I70.462Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, left leg
- I70.463Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, bilateral legs
- I70.468Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene, other extremity