ICD-10 I83.004
Billable / Specific HCC v28: 107Varicose veins of unspecified lower extremity with ulcer of heel and midfoot
About ICD-10-CM I83.004
ICD-10-CM code I83.004 represents Varicose veins of unspecified lower extremity with ulcer of heel and midfoot. This is a billable/specific code in the Circulatory System chapter (block I83). The 2026 edition of ICD-10-CM I83.004 became effective on October 1, 2025.
Coding Tips for I83.004
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I83.004 is a CMS-HCC v28 risk-adjustment code (category 107). 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under I83.004. Per CMS ICD-10-CM Tabular 2026.
- Varicose veins of unspecified lower extremity with ulcer of plantar surface of midfoot
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.
Medicare LCD Coverage for I83.004
Local Coverage Determinations (LCDs) from CMS MACs that list I83.004 as a covered diagnosis.
Showing top 10 of 36 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I83.004.
3 Medicare
CPT Codes Commonly Billed with I83.004
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 I83.004 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 |
|---|---|---|
| I83.004 | 4540 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I83.004
Other codes in section I80-I89 (Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified).
ICD-10 I83.004, Billing FAQ
Is ICD-10 code I83.004 billable? +
Yes, I83.004 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to I83.004? +
ICD-10 I83.004 includes: Varicose veins of unspecified lower extremity with ulcer of plantar surface of midfoot.
Does I83.004 affect Medicare Advantage HCC risk adjustment? +
Yes. I83.004 maps to CMS-HCC v28 category 107. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does I83.004 map to? +
Per CMS GEMs, I83.004 maps to ICD-9 codes: 4540. 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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