ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I70.628

Billable / Specific HCC v28: 108

Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, other extremity

I70
Block
0
Synonyms
268
LCDs
11
Payer Policies
0
Linked CPTs

About ICD-10-CM I70.628

ICD-10-CM code I70.628 represents Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, other extremity. This is a billable/specific code in the Circulatory System chapter (block I70). The 2026 edition of ICD-10-CM I70.628 became effective on October 1, 2025.

Coding Tips for I70.628

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I70.628 is a CMS-HCC v28 risk-adjustment code (category 108). 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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 108
ESRD-HCC
Category 108
RxHCC (Part D)
Category 108

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for I70.628

Local Coverage Determinations (LCDs) from CMS MACs that list I70.628 as a covered diagnosis.

268 LCDs

Showing top 10 of 268 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8918 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8936 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8910 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70548 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8913 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8912 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8914 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70547 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8901 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8902 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I70.628.

11 policies

5 Medicare

Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
Policy ID: ART-56423
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476
Billing and Coding: Homocysteine Level, Serum
Policy ID: ART-56675
Billing and Coding: Routine Foot Care
Policy ID: ART-56680
Billing and Coding: Magnetic Resonance Angiography (MRA)
Policy ID: ART-56747

CPT Codes Commonly Billed with I70.628

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for I70.628

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert I70.628 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I70.628 44030 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To I70.628

Other codes in section I70-I79 (Diseases of arteries, arterioles and capillaries).

I70 Atherosclerosis (non-billable) I70.0 Atherosclerosis of aorta I70.1 Atherosclerosis of renal artery I70.2 Atherosclerosis of native arteries of the extremities (non-billable) I70.20 Unspecified atherosclerosis of native arteries of extremities (non-billable) I70.201 Unspecified atherosclerosis of native arteries of extremities, right leg I70.202 Unspecified atherosclerosis of native arteries of extremities, left leg I70.203 Unspecified atherosclerosis of native arteries of extremities, bilateral legs I70.208 Unspecified atherosclerosis of native arteries of extremities, other extremity I70.209 Unspecified atherosclerosis of native arteries of extremities, unspecified extremity I70.21 Atherosclerosis of native arteries of extremities with intermittent claudication (non-billable) I70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg I70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg I70.213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs I70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity I70.219 Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity I70.22 Atherosclerosis of native arteries of extremities with rest pain (non-billable) I70.221 Atherosclerosis of native arteries of extremities with rest pain, right leg I70.222 Atherosclerosis of native arteries of extremities with rest pain, left leg I70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs

ICD-10 I70.628, Billing FAQ

Is ICD-10 code I70.628 billable? +

Yes, I70.628 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does I70.628 affect Medicare Advantage HCC risk adjustment? +

Yes. I70.628 maps to CMS-HCC v28 category 108. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does I70.628 map to? +

Per CMS GEMs, I70.628 maps to ICD-9 codes: 44030. 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 May 31, 2026.

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