ICD-10 I70.269
Billable / Specific HCC v28: 106 CCAtherosclerosis of native arteries of extremities with gangrene, unspecified extremity
About ICD-10-CM I70.269
ICD-10-CM code I70.269 represents Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity. This is a billable/specific code in the Circulatory System chapter (block I70). The 2026 edition of ICD-10-CM I70.269 became effective on October 1, 2025.
Coding Tips for I70.269
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I70.269 is a CMS-HCC v28 risk-adjustment code (category 106). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
I70.269 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I70.269
Local Coverage Determinations (LCDs) from CMS MACs that list I70.269 as a covered diagnosis.
Showing top 10 of 114 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I70.269.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with I70.269
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 11006 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 97607 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11008 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11005 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11012 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11010 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 97608 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 97610 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 11011 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
- 29581 CMS LCD: Billing and Coding: Wound and Ulcer Care CMS LCD
Convert I70.269 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I70.269 | 44024 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I70.269
Other codes in section I70-I79 (Diseases of arteries, arterioles and capillaries).
ICD-10 I70.269, Billing FAQ
Is ICD-10 code I70.269 billable? +
Yes, I70.269 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I70.269 affect Medicare Advantage HCC risk adjustment? +
Yes. I70.269 maps to CMS-HCC v28 category 106. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I70.269 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with I70.269? +
Procedures frequently paired with I70.269 include: 11006, 97607, 11008, 11005, 11012.
What ICD-9 codes does I70.269 map to? +
Per CMS GEMs, I70.269 maps to ICD-9 codes: 44024. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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