What is the ICD‑10‑CM code for a chronic total occlusion of the left superficial femoral artery in an elderly patient? | Rounds What is the ICD‑10‑CM code for a chronic total occlusion of the left superficial femoral artery in an elderly patient? | Rounds
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What is the ICD‑10‑CM code for a chronic total occlusion of the left superficial femoral artery in an elderly patient?

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Chronic total occlusion of left superficial femoral artery

Chronic total occlusion of an extremity artery is coded with ICD-10-CM I70.92. [1] The underlying atherosclerotic manifestation in the left leg is coded with an additional I70.2x code based on documented clinical severity (intermittent claudication, rest pain, or ulceration/gangrene). [1], [2]

Chronic total occlusion code

  • I70.92 – Chronic total occlusion of artery of the extremities [1]

Left leg atherosclerosis manifestation codes (required additional code)

Atherosclerosis of the left leg is coded by symptom category. [2]

  • I70.212 – Atherosclerosis of native arteries of extremities with intermittent claudication, left leg [2]
  • I70.222 – Atherosclerosis of native arteries of extremities with rest pain, left leg [3]
  • I70.242 – Atherosclerosis of native arteries of left leg with ulceration of calf [4]

Key coding clarification

ICD-10-CM uses I70.92 specifically for chronic total occlusion and does not encode the superficial femoral artery location within I70.92. [1] The superficial femoral artery involvement is typically captured by the clinical documentation and may influence supporting codes if additional laterality/site-specific documentation exists, but I70.92 remains the chronic total occlusion code. [1]

Code selection based on available documentation

If the documentation includes only chronic total occlusion without specifying the left-leg symptom category, coding should include I70.92 plus the most specific available left-leg atherosclerosis (I70.2x) code supported by the documentation. [1], [2] If documentation specifies intermittent claudication, I70.212 should be used. [2] If documentation specifies rest pain, I70.222 should be used. [3] If documentation specifies ulceration, I70.242 should be used. [4]

Common pitfalls to avoid

Choosing only an I70.2x left-leg atherosclerosis code without adding I70.92 can omit the documented chronic total occlusion component. [1], [2] Choosing an I70.2x category that does not match the documented symptom severity (for example, using rest pain when ulceration is documented) can misclassify clinical severity. [2], [3], [4]

Target documentation for accurate coding

The symptom category for I70.212 vs I70.222 vs I70.242 should be supported by chart documentation of intermittent claudication, rest pain, or ulceration. [2], [3], [4]

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