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

I70.269 is the billable ICD-10-CM code for atherosclerosis of native arteries of extremities with gangrene, unspecified extremity, in category I70 (Atherosclerosis) of the Diseases of arteries, arterioles and capillaries section. As a principal diagnosis it groups to MS-DRG 299 Peripheral Vascular Disorders with MCC, MS-DRG 300 Peripheral Vascular Disorders with CC, MS-DRG 301 Peripheral Vascular Disorders without CC/MCC (MDC 05 MDC 05: Diseases and Disorders of the Circulatory System); or MS-DRG 791 Prematurity with Major Problems, MS-DRG 793 Full Term Neonate with Major Problems (MDC 15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period). It maps to HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 45 principal diagnoses. 6 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
I70.269
billable FY2027 ICD-10-CM code
Category
I70 Atherosclerosis
Chapter
9: Diseases of the circulatory system (I00-I99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 263
POA reporting
Required

Tabular list notes for I70.269

The tabular list has no notes on I70.269 itself; the notes below apply from its parent headings.

Inherited from I70 (Atherosclerosis)

Includes
  • arteriolosclerosis
  • arterial degeneration
  • arteriosclerosis
  • arteriosclerotic vascular disease
  • arteriovascular degeneration
  • atheroma
  • endarteritis deformans or obliterans
  • senile arteritis
  • senile endarteritis
  • vascular degeneration
Excludes2 (not part of this condition, may be coded together)
  • 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)
Use additional code
  • 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)

Inherited from I70.2 (Atherosclerosis of native arteries of the extremities)

Inclusion terms
  • Mönckeberg's (medial) sclerosis
Excludes2 (not part of this condition, may be coded together)
  • atherosclerosis of bypass graft of extremities (I70.30-I70.79)
Use additional code
  • code, if applicable, to identify chronic total occlusion of artery of extremity (I70.92)

Inherited from I70.26 (Atherosclerosis of native arteries of extremities with gangrene)

Includes
  • 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
Use additional code
  • code to identify the severity of any ulcer (L97.-, L98.49-), if applicable

MS-DRG grouping when I70.269 is the principal diagnosis

MS-DRG v44 groups for I70.269 as principal diagnosis
MDCMS-DRGs
05 MDC 05: Diseases and Disorders of the Circulatory System299300301
15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period791793

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for I70.269 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, I70.269 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 45 codes in its exclusion list. Check I70.269 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.
  • Medicare Code Editor: age conflict: adult diagnosis (age 15 to 124); unspecified code where a laterality-specific code exists.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, I70.269 maps to HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list I70.269

6 current Medicare billing and coding articles list I70.269 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM I70.269 mean?

I70.269 means atherosclerosis of native arteries of extremities with gangrene, unspecified extremity. It is one of 25 billable codes under I70, atherosclerosis.

Which MS-DRG does I70.269 group to?

As the principal diagnosis, I70.269 groups to MS-DRG 299 Peripheral Vascular Disorders with MCC, MS-DRG 300 Peripheral Vascular Disorders with CC, MS-DRG 301 Peripheral Vascular Disorders without CC/MCC (MDC 05 MDC 05: Diseases and Disorders of the Circulatory System); or MS-DRG 791 Prematurity with Major Problems, MS-DRG 793 Full Term Neonate with Major Problems (MDC 15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does I70.269 map to an HCC?

Yes: HCC 263, Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene, in the PY2027 CMS-HCC V28 mapping.

Is I70.269 a CC or MCC?

I70.269 is a CC under MS-DRG v44; 45 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.