Atherosclerosis of the extremities is divided into three categories: native arteries, bypass grafts, and chronic total occlusion. It is caused by plaque buildup in the artery wall, which causes the artery to lose elasticity over time and can lead to complications like pain and gangrene. Coders must have documentation specifying atherosclerosis and use the appropriate ICD-9 and ICD-10 codes depending on location and severity.

1. Atherosclerosis of the extremities (Monckeberg’s Sclerosis)
is a peripheral vascular disease (PVD) that occurs in the arteries of
extremities; which is why it is sometimes referred to as peripheral
artery disease (PAD). The coder however, must have the
physician’s documentation indicating the PAD is due to
atherosclerosis to ensure correct code assignment (see note). PAD
due to atherosclerosis is caused by plague made up of deposits of
fatty substances, cholesterol, cellular waste products, calcium,
and fibrin built up inside the artery wall. The artery loses its
elasticity due to the blockage which gradually develops into
complications such as rest pain, intermittent claudication,
ulcerations, and even gangrene.
NOTE: Peripheral Arterial Disease not specified as atherosclerotic
is coded to 443.9, Peripheral Vascular Disease, Unspecified in ICD-
9 CM and I73.9, Peripheral Vascular Disease, Unspecified in ICD-10
CM.
WHAT IS ATHEROSCLEROSIS OF THE EXTREMITIES?
WHAT TO EXPECT
1 What is Atherosclerosis of
the Extremities?
2 Atherosclerosis of Native
Arteries of the Extremities
3 Atherosclerosis of Bypass
Graft of Extremities & Total
Occlusion
4 Requests for Coding Topics
“Physician’s
documentation must
indicate
atherosclerosis.”
July 2014
Volume 1 Issue 7
By Cynthia Brown, MBA, RHIT, CCS
www.cyntcodinghealthinformationservices.com
CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984
http://www.cyntcodinghealthinformationservices.com
Cynthia@cyntcodinghealthinformationservices.com [phone]
CODING YESTERDAY’S NOMENCLATURE TODAY®
Coding Atherosclerosis of the Extremities
in ICD-9 CM & ICD-10 CM
CODING NEWSLETTER FOR HEALTHCARE
CODING PROFESSIONALS

2. Page 2 Coding Yesterday’s Nomenclature Today
In ICD-9 CM and ICD-10 CM the codes for atherosclerosis of
the extremities are divided into three categories 1) of native
arteries of the extremities; 2) of bypass graft of extremities; and
3) chronic total occlusion of artery of the extremities.
NATIVE ARTERIES: Use additional code, if applicable to identify
chronic total occlusion of artery of the extremities in both ICD-9
CM (440.4) and ICD-10 CM (I70.92) throughout the subcategory.
ICD-9 CM: 440.20 Atherosclerosis of the extremities (AOE),
unspecified
ICD-10 CM: I70.201-I70.209 (The extremity is specified in ICD-10)
ICD-9 CM: 440.21 AOE with intermittent claudication
ICD-10 CM: I70.211-I70.219
ICD-9 CM: 440.22 AOE with rest pain
ICD-10 CM: I70.221-I70.229
ICD-9 CM: 440.23 AOE with ulceration (Use additional code for
associated ulceration (707.10-707.19, 707.8, 707.9)
ICD-10 CM: I70.231-I70.239 (Use additional code to identify
severity of ulcer, L97. - with 5th
character 1) OR I70.241-I70.249
(Use additional code to identify severity of ulcer, L97. - with 5th
character 2) OR I70.25 (Use additional code to identify severity of
ulcer, L98.49-)
ICD-9 CM: 440.24 AOE with gangrene (Use additional code for any
associated ulceration (707.10-707.19, 707.8, 707.9)
ICD-10 CM: I70.261-I70.269 (Use additional code to identify
severity of ulcer, L98.49-, IF APPLICABLE)
ICD-9 CM: 440.29 Other
ICD-10 CM: I70.291-I70.299
REMEMBER IN ICD-10 CM CODES THERE IS A DISTINCTION BETWEEN
RIGHT AND LEFT EXTREMITY, BILATERAL, OTHER AND UNSPECIFIED
EXTREMITY WHICH IS NOT FOUND IN ICD-9 CM CODES.
www.cyntcodinghealthinformationservices.com
“Arterial/Venous Circulation
in Legs”
“Atherosclerosis of
extremities divided into
3 categories.”
ICD-9 CM and ICD-10 CM CODES

3. Coding Yesterday’s Nomenclature Today
ICD-9 CM and ICD-10 CM CODES
Bypass Graft of Extremities:
ICD-9 CM: 440.30 of unspecified graft
ICD-10 CM: I70.301-I70.309 OR I70.311-I70.319 OR I70.321-I70.329 OR
I70.331-339 OR I70.341-I70.349 OR I70.35 OR I70.361-I70.369 OR I70.391-
I70.399 *This subcategory requires the coder to use an additional code, if
applicable for chronic total occlusion of artery of extremity (I70.92); NOT
REQUIRED IN ICD-9 CM. This subcategory includes the complications of
the atherosclerosis such as rest pain, intermittent claudication, etc; NOT
SEEN IN ICD-9 CM. The coder must follow the instructional note for each
complication as described previously.
ICD-9 CM: 440.31 of Autologous vein bypass graft
ICD-10 CM: I70.401-I70.409 OR I70.411-I70.419 OR I70.421-I70.429 OR
I70.431-439 OR I70.441-I70.449 OR I70.45 OR I70.461-I70.469 OR I70.491-
I70.499 *This subcategory requires the coder to use an additional code, if
applicable for chronic total occlusion of artery of extremity (I70.92); NOT
REQUIRED IN ICD-9 CM. This subcategory includes the complications of
the atherosclerosis such as rest pain, intermittent claudication, etc; NOT
SEEN IN ICD-9 CM. The coder must follow the instructional note for each
complication as described previously.
ICD-9 CM: 440.32 of Nonautologous biological bypass graft
ICD-10 CM: I70.501-I70.509 OR I70.511-I70.519 OR I70.521-I70.529 OR
I70.531-539 OR I70.541-I70.549 OR I70.55 OR I70.561-I70.569 OR I70.591-
I70.599 *This subcategory requires the coder to use an additional code, if
applicable for chronic total occlusion of artery of extremity (I70.92); NOT
REQUIRED IN ICD-9 CM. This subcategory includes the complications of
the atherosclerosis such as rest pain, intermittent claudication, etc; NOT
SEEN IN ICD-9 CM. The coder must follow the instructional note for each
complication as described previously.
NOTE: ICD-10 CM added a subcategory (I70.601-I70.699) nonbiological
bypass graft(s) of the extremities and subcategory (I70.701-I70.799)
other type of bypass graft(s) that IS NOT found in ICD-9 CM. The coder
should follow the same instructional notes as in the other subcategories.
ICD-9 CM: 440.4 chronic total occlusion of artery of the extremities
(Code 1st
atherosclerosis of arteries of the extremities (440.20-440.29,
440.30-440.32)
ICD-10 CM: I70.92 chronic total occlusion of artery of the extremities
(Code 1st
atherosclerosis of arteries of the extremities (I70.2-, I70.3-,
I70.4-, I70.5-, I70.6-, I70.7-)
AHIMA approved ICD-10 CM/PCS
Trainer
ALL THINGS CODING®
“Accurate and
complete coding is a
must in today’s
economically
challenged healthcare
environment.”

4. Page 4 Coding Yesterday’s Nomenclature Today
CCHIS Professional Affiliates
AHIMA
GHIMA
AHIMA approved ICD-10 CM/PCS
Trainer
EDWOSB/WOSB
VOSB
SCORE Atlanta
CyntCoding Health Information Services
P.O. BOX 3019
Decatur, GA 30031
Phone:
404-992-8984
E-Fax:
678-805-4919
E-mail:
cyntcoder@cyntcodinghealthinformationservices.com
Requests for Coding Topics
E-mail your coding topics or request your FREE issue of the
CCHIS Newsletter by visiting the website and leaving your
contact information. You may also contact me at:
cyntcoder@cyntcodinghealthinformationservices.com
CCHIS NEWSLETTER
TERMS AND CONDITIONS OF USE
All content provided in this “CCHIS Newsletter” is for informational purposes only. The owner
of this newsletter makes no representations as to the accuracy or completeness of any information
in this newsletter or found by following any link in this newsletter.
The owner of www.cyntcodinghealthinformationservices.com will not be liable for any errors or
omissions in information nor for the availability of this information. The owner will not be liable
for any losses, injuries, or damages from the display or use of this information. The terms and
conditions are subject to change at any time with or without notice.
The owner of http://cyntcodinghealthinformationservices.com will not be liable for any errors or
omissions in information nor for the availability of this information. The owner will not be liable
for any losses, injuries, or damages from the display or use of this information. The terms and
conditions are subject to change at any time with or without notice.
CODING YESTERDAY’S NOMENCLATURE TODAY®
www.cyntcodinghealthinformationservices.com