2027 ICD-10-CM Diagnosis Code I70.368Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity
ICD-10-CM Codes›I00–I99›I70-I79›I70
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 263
- Chronic Condition
I70.368 is a billable ICD-10-CM diagnosis code for atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other 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. 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 46 closely related codes. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gangrene and Peripheral and visceral vascular disease.
For Medicare Advantage risk adjustment, I70.368 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
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for I70.368.
Medicare Risk Adjustment (HCC)Billing
I70.368 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.
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.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to I70.368: its own notes plus those printed at I70.36, I70.3, 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.
- arteriolosclerosis
- arterial degeneration
- arteriosclerosis
- arteriosclerotic vascular disease
- arteriovascular degeneration
- atheroma
- endarteritis deformans or obliterans
- senile arteritis
- senile endarteritis
- vascular degeneration
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
- 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.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name I70.368, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming I70.368: they are not reported together with it, unless the two conditions are unrelated.
Code First 1
These codes say to code first a condition named in the note, and I70.368 is one of the conditions named.
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.
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 I70.368 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About I70.368Overview
Is I70.368 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does I70.368 group to?
When atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity is the principal diagnosis on an inpatient stay, it groups to MS-DRG 301, 300, 299, with relative weights from 0.7132 to 1.5840 depending on complications. Higher weights mean higher Medicare reimbursement.
Is I70.368 a CC or MCC?
CMS lists I70.368 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 46 closely related codes in its exclusion list.
Who can I70.368 be reported for?
The Medicare Code Editor checks atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other extremity against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
Can I70.368 be reported with a code from T82.8?
Not as a rule. The Excludes1 note at I70.3, which applies to I70.368, lists "embolism or thrombus of bypass graft(s) of extremities (T82.8-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is I70.368?
I70.368 (atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene, other 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 I70.368 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I70.368 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.
