ICD-10 I83.215
Billable / Specific HCC v28: 107 CCVaricose veins of right lower extremity with both ulcer other part of foot and inflammation
About ICD-10-CM I83.215
ICD-10-CM code I83.215 represents Varicose veins of right lower extremity with both ulcer other part of foot and inflammation. This is a billable/specific code in the Circulatory System chapter (block I83). The 2026 edition of ICD-10-CM I83.215 became effective on October 1, 2025.
Coding Tips for I83.215
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I83.215 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.
I83.215 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under I83.215. Per CMS ICD-10-CM Tabular 2026.
- Varicose veins of right lower extremity with both ulcer of toe and inflammation
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 Varicose veins of right lower extremity with both ulcer other part of foot and inflammation. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I83.215
Local Coverage Determinations (LCDs) from CMS MACs that list I83.215 as a covered diagnosis.
Showing top 10 of 486 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I83.215.
5 Medicare
CPT Codes Commonly Billed with I83.215
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 36470 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 36473 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 37760 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 36474 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 37765 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 37735 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 37780 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 93971 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 36466 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
- 37761 CMS LCD: Billing and Coding: Treatment of Varicose Veins of the Lower Extremities CMS LCD
Convert I83.215 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 |
|---|---|---|
| I83.215 | 4542 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I83.215
Other codes in section I80-I89 (Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified).
ICD-10 I83.215, Billing FAQ
Is ICD-10 code I83.215 billable? +
Yes, I83.215 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 I83.215? +
ICD-10 I83.215 includes: Varicose veins of right lower extremity with both ulcer of toe and inflammation.
Does I83.215 affect Medicare Advantage HCC risk adjustment? +
Yes. I83.215 maps to CMS-HCC v28 category 107. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I83.215 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 I83.215? +
Procedures frequently paired with I83.215 include: 36470, 36473, 37760, 36474, 37765.
What ICD-9 codes does I83.215 map to? +
Per CMS GEMs, I83.215 maps to ICD-9 codes: 4542. 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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