2027 ICD-10-CM Diagnosis Code I70.269Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity

ICD-10-CM Codes›I00–I99›I70-I79›I70

ICD-10-CM I70.269
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

I70.269 is a billable ICD-10-CM diagnosis code for atherosclerosis of native arteries of extremities with gangrene, unspecified extremity. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 299 through 301, 791, 793. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 45 closely related codes. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124) and flagged as an unspecified code, since codes identifying laterality exist in the same family. Coders also document this condition as arteriosclerotic gangrene. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gangrene and Peripheral and visceral vascular disease.

For Medicare Advantage risk adjustment, I70.269 maps to CMS-HCC Category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) under the V28 model, adding a risk factor of about 1.118 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
I70.269
Billable Status
Yes — Valid for Submission
Code Describes
Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity
Short Description
Athscl native arteries of extrm w gangrene, unsp extremity
Parent Code
I70.26
Atherosclerosis of native arteries of extremities with gangrene

Code Classification

ChapterI00–I99Diseases of the circulatory system
SectionI70-I79Diseases of arteries, arterioles and capillaries
CategoryI70Atherosclerosis
This CodeI70.269Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity

Code EditsBilling

Medicare Code Editor checks that affect claim validity for I70.269.

Adult diagnoses
The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).
Unspecified codes
Unspecified codes exist in the ICD-10-CM classification for circumstances when documentation in the medical record does not provide the level of detail needed to support reporting a more specific code. However, in the inpatient setting, there should generally be very limited and rare circumstances for which the laterality (right, left, bilateral) of a condition is unable to be documented and reported. The following pages contain the list of unspecified ICD-10-CM diagnosis codes for which there is a more specific code to identify laterality (right, left, bilateral) within that code family.

Medicare Risk Adjustment (HCC)Billing

I70.269 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 263— Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene
Payment HCC · PY 2027 one of 127 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+1.118
community, non-dual, aged · ranges 0.696–1.432 across segments
Hierarchy
Supersedes HCC 264, HCC 383, and HCC 409
less severe related categories are not paid alongside HCC 263
Prior Model (CMS-HCC V24)
HCC 106
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 106 · ESRD (V21): HCC 106 · ESRD (V24): HCC 106
ESRD V21 weights: 0.321 dialysis, 0.754–1.385 functioning graft · ESRD V24 weights: 0.358 dialysis, 0.873–1.740 functioning graft
Part D (RxHCC)
Not mapped
I70.269 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Arteriosclerotic gangrene
  • Gangrene due to peripheral vascular disease
  • Gangrene of limb due to atherosclerosis of artery of limb
  • Necrosis of artery

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to I70.269: its own notes plus those printed at I70.26, I70.2, I70, and Chapter 9. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From I70.26 Atherosclerosis of native arteries of extremities with gangrene applies to 5 codes
  • any condition classifiable to I70.21-, I70.22-, I70.23-, I70.24-, and I70.25-
  • chronic limb-threatening ischemia of native arteries of extremities with gangrene
  • critical limb ischemia of native arteries of extremities with gangrene
From I70 Atherosclerosis applies to 246 codes
  • arteriolosclerosis
  • arterial degeneration
  • arteriosclerosis
  • arteriosclerotic vascular disease
  • arteriovascular degeneration
  • atheroma
  • endarteritis deformans or obliterans
  • senile arteritis
  • senile endarteritis
  • vascular degeneration

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From I70.2 Atherosclerosis of native arteries of the extremities applies to 40 codes
  • atherosclerosis of bypass graft of extremities (I70.30-I70.79)
From I70 Atherosclerosis applies to 246 codes
  • arteriosclerotic cardiovascular disease (I25.1-)
  • arteriosclerotic heart disease (I25.1-)
  • atheroembolism (I75.-)
  • cerebral atherosclerosis (I67.2)
  • coronary atherosclerosis (I25.1-)
  • mesenteric atherosclerosis (K55.1)
  • precerebral atherosclerosis (I67.2)
  • primary pulmonary atherosclerosis (I27.0)
From Chapter 9 (I00-I99) Diseases of the circulatory system applies to 1,433 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From I70.26 Atherosclerosis of native arteries of extremities with gangrene applies to 5 codes
  • code to identify the severity of any ulcer (L97.-, L98.49-), if applicable
From I70.2 Atherosclerosis of native arteries of the extremities applies to 40 codes
  • code, if applicable, to identify chronic total occlusion of artery of extremity (I70.92)
From I70 Atherosclerosis applies to 246 codes
  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name I70.269, its category, or a range that includes it.

Excludes1 4

These codes carry an Excludes1 note naming I70.269: they are not reported together with it, unless the two conditions are unrelated.

  • I77.6 Arteritis, unspecified
    deformans (I70.-) names I70.-, which includes this code
  • I77.6 Arteritis, unspecified
    obliterans (I70.-) names I70.-, which includes this code
  • I77.6 Arteritis, unspecified
    senile (I70.-) names I70.-, which includes this code
  • I96 Gangrene, not elsewhere classified
    gangrene in atherosclerosis of native arteries of the extremities (I70.26) names I70.26, which includes this code

Code First 1

These codes say to code first a condition named in the note, and I70.269 is one of the conditions named.

  • I70.92 Chronic total occlusion of artery of the extremities
    atherosclerosis of arteries of the extremities (I70.2-, I70.3-, I70.4-, I70.5-, I70.6-, I70.7-) names I70.2-, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR CIR028
Gangrene
Default principal diagnosis: inpatient No · outpatient No
CCSR CIR026
Peripheral and visceral vascular disease
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Atherosclerosis

    a thickening and loss of elasticity of the walls of arteries that occurs with formation of atherosclerotic plaques within the arterial intima.

Patient EducationClinical

Atherosclerosis

Atherosclerosis is a condition in which plaque builds up inside your arteries. Plaque is a sticky substance made up of cholesterol, fat, blood cells, calcium, and other substances found in the blood. Over time, plaque hardens and causes your arteries to narrow. That limits the flow of oxygen-rich blood to your body.

The full article covers:

  • What is atherosclerosis?
  • What causes atherosclerosis?
  • Who is more likely to develop atherosclerosis?
  • What are the symptoms of atherosclerosis?
  • What other problems can atherosclerosis cause?
  • How is atherosclerosis diagnosed?
  • What are the treatments for atherosclerosis?
  • Can atherosclerosis be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert I70.269 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
440.24 Ath ext ntv art gngrene
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About I70.269Overview

Is I70.269 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report atherosclerosis of native arteries of extremities with gangrene, unspecified extremity on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does I70.269 group to?

When atherosclerosis of native arteries of extremities with gangrene, unspecified extremity is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 301, 300, 299, with relative weights from 0.7132 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is I70.269 a CC or MCC?

CMS lists I70.269 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 45 closely related codes in its exclusion list.

Who can I70.269 be reported for?

The Medicare Code Editor checks atherosclerosis of native arteries of extremities with gangrene, unspecified extremity against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

Does I70.269 need an additional code?

When the condition applies, yes. The Use Additional Code note at I70.26, which applies to I70.269, reads: code to identify the severity of any ulcer (L97.-, L98.49-), if applicable. The additional code is reported after I70.269.

What HCC is I70.269?

I70.269 (atherosclerosis of native arteries of extremities with gangrene, unspecified extremity) maps to CMS-HCC Category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene), commonly written as HCC 263, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 106 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does I70.269 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, I70.269 adds a risk adjustment factor of about 1.118 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.696 to 1.432 depending on the payment segment). HCC 263 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 263 category page.