Q: When a diabetic patient has arteriosclerotic peripheral artery disease (PAD), should an additional ICD-10-CM code be assigned from subcategory I70.2- (atherosclerosis of native arteries of extremities) to describe the affected vessel and laterality?
A: Yes. According to Coding Clinic, Third Quarter 2018, you should assign ICD-10-CM code E11.51 (Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene) along with an additional code from subcategory I70.2- to fully capture the patient's condition.
A code from category I70.2- can only be reported when the documentation provides specificity about the atherosclerosis such as laterality, affected vessel, as well as additional manifestations of the disease (i.e., claudication, rest pain, etc.).
Keep in mind that according to the 2020 ICD-10-CM Official Guidelines for Coding and Reporting, multiple codes should not be used when the classification provides a combination code that clearly identifies all of the elements documented in the diagnosis.
“When the combination code lacks necessary specificity in describing the manifestation or complication, an additional code should be used as a secondary code,” the guidelines say.
Editor’s note: Sarah Humbert, RHIA, AHIMA-certified ICD-10-CM/PCS trainer, coding and compliance manager at KIWI-TEK LLC, and Temeka Davis, RHIT, coding manager at KIWI-TEK LLC, answered this question during HCPro’s webinar Simplify Complex ICD-10-CM Coding for Diabetes.
This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
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categoryCode : I70
diagnosisCode : 202
fullCode : I70202
abbreviatedDescription : Unsp athscl native arteries of extremities, left leg
fullDescription : Unspecified atherosclerosis of native arteries of extremities, left leg
categoryTitle : Atherosclerosis
billable : billable
FHIR Resource for ICD icd10I70202: Unspecified atherosclerosis of native arteries of extremities, left leg
{ "identifier": [ { "system": "//hl7.org/fhir/sid/icd-10-cm", "use": "usual", "assigner": { "display": "World Health Organization (WHO)" }, "value": "I70202" } ], "extension": [ { "extension": [ { "valueString": "I70", "url": "categoryCode" }, { "valueString": "202", "url": "diagnosisCode" }, { "valueString": "I70202", "url": "fullCode" }, { "valueString": "Unsp athscl native arteries of extremities, left leg", "url": "abbreviatedDescription" }, { "valueString": "Unspecified atherosclerosis of native arteries of extremities, left leg", "url": "fullDescription" }, { "valueString": "Atherosclerosis", "url": "categoryTitle" }, { "valueString": "billable", "url": "billable" } ], "url": "//1up.health/dev/fhir/doc/extension/DataTypeCoding/icd" } ], "code": "I70202", "system": "//hl7.org/fhir/sid/icd-10-cm", "display": "I70202,Unsp athscl native arteries of extremities, left leg", "id": "icd10I70202", "version": "2016", "resourceType": "DataTypeCoding" }I70202: Unspecified atherosclerosis of native arteries of extremities, left leg. 1uphealth is the most comprehensive resource to lookup and find ICD codes (international classification of diseases) and data online, from the years 2010-2021. ICD-10 or ICD-10-CM is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical international classification list by the World Health Organization (WHO). Medical search and APIs for ICD10, SNOMED, LOINC, NPIs and much more by 1upHealth.
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R94.31
Abnormal electrocardiogram [ECG] [EKG]
R01.0
Benign and innocent cardiac murmurs
R01.1
Cardiac murmur, unspecified
R42
Dizziness and Giddiness
I34.0
Nonrheumatic mitral (valve) insufficiency
I34.1
Nonrheumatic mitral (valve) prolapse
I34.2
Nonrheumatic mitral (valve) stenosis
I34.8
Other nonrheumatic mitral valve disorders
I34.9
Nonrheumatic mitral valve disorder, unspecified
G45.9
Transient cerebral ischemic attack, unspecified
R07.9
Chest pain, unspecified
I36.0
Nonrheumatic tricuspid (valve) stenosis
I36.1
Nonrheumatic tricuspid (valve) insufficiency
I36.2
Nonrheumatic tricuspid (valve) stenosis with insufficiency
I36.8
Other nonrheumatic tricuspid valve disorders
I36.9
Nonrheumatic tricuspid valve disorder, unspecified
I25.10
Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110
Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111
Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118
Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119
Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I50.20
Unspecified systolic (congestive) heart failure
I50.30
Unspecified diastolic (congestive) heart failure
I50.32
Chronic diastolic (congestive) heart failure
I35.0
Nonrheumatic aortic (valve) stenosis
I35.1
Nonrheumatic aortic (valve) insufficiency
I35.2
Nonrheumatic aortic (valve) stenosis with insufficiency
I35.8
Other nonrheumatic aortic valve disorders
I35.9
Nonrheumatic aortic valve disorder, unspecified
I27.0
Primary pulmonary hypertension
I11.9
Hypertensive heart disease without heart failure
I37.0
Nonrheumatic pulmonary valve stenosis
I37.1
Nonrheumatic pulmonary valve insufficiency
I37.2
Nonrheumatic pulmonary valve stenosis with insufficiency
I37.8
Other nonrheumatic pulmonary valve disorders
I37.9
Nonrheumatic pulmonary valve disorder, unspecified
I48.0
Paroxysmal atrial fibrillation
I48.2
Chronic atrial fibrillation
I48.91
Unspecified atrial fibrillation
R06.00
Dyspnea, unspecified
R06.09
Other forms of dyspnea
R06.89
Other abnormalities of breathing
I51.9
Heart disease, unspecified
R00.0
Tachycardia, unspecified
I42.0
Dilated cardiomyopathy
I42.5
Other restrictive cardiomyopathy
I42.8
Other cardiomyopathies
I42.9
Cardiomyopathy, unspecified
I47.0
Re-entry ventricular arrhythmia
I47.2
Ventricular tachycardia
I25.2
Old myocardial infarction
I31.3
Pericardial effusion (noninflammatory)
I31.9
Disease of pericardium, unspecified
I48.1
Persistent atrial fibrillation
I48.3
Typical atrial flutter
I48.4
Atypical atrial flutter
I25.710
Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711
Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.718
Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719
Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I47.1
Supraventricular tachycardia
I49.2
Junctional premature depolarization
I49.8
Other specified cardiac arrhythmias
R00.1
Bradycardia, unspecified
I06.0
Rheumatic aortic stenosis
I07.0
Rheumatic tricuspid stenosis
I07.1
Rheumatic tricuspid insufficiency
I07.2
Rheumatic tricuspid stenosis and insufficiency
I07.8
Other rheumatic tricuspid valve diseases
I07.9
Rheumatic tricuspid valve disease, unspecified
I11.0
Hypertensive heart disease with heart failure
I44.4
Left anterior fascicular block
I44.5
Left posterior fascicular block
I45.0
Right fascicular block
I49.40
Unspecified premature depolarization
I49.5
Sick sinus syndrome
I49.9
Cardiac arrhythmia, unspecified
I77.810
Thoracic aortic ectasia
R06.82
Tachypnea, not elsewhere classified
R94.39
Abnormal result of other cardiovascular function study
I20.8
Other forms of angina pectoris
I20.9
Angina pectoris, unspecified
J80
Acute respiratory distress syndrome
R06.9
Unspecified abnormalities of breathing
R06.81
Apnea, not elsewhere classified
I70.209
Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
I33.9
Acute and subacute endocarditis, unspecified
Z01.810
Encounter for preprocedural cardiovascular examination
I05.0
Rheumatic mitral stenosis
I05.1
Rheumatic mitral insufficiency
I05.2
Rheumatic mitral stenosis with insufficiency
I06.1
Rheumatic aortic insufficiency
I06.2
Rheumatic aortic stenosis with insufficiency
I09.89
Other specified rheumatic heart diseases
I08.0
Rheumatic disorders of both mitral and aortic valves
I08.8
Other rheumatic multiple valve diseases
I08.9
Rheumatic multiple valve disease, unspecified
What is atherosclerosis of native arteries of extremities?
What is the ICD
Code | Description |
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 |
I70.221 | Atherosclerosis of native arteries of extremities with rest pain, right leg |