ICD-10 Codes

New CLI/CLTI Coding Strategies for ICD-10-CM

A Major Step for Tracking Patient Treatments and Outcomes

A coalition organized by the CLI Global Society announced its proposal to distinctly recognize “Critical Limb Ischemia” and “Chronic Limb-Threatening Ischemia” in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) was approved by the CDC and went into effect October 1, 2020.  Click here to view the press release and “How To” document.

Live Webinar March 5, 2021

Friday, March 5 at 1:00pm EST: Critical Limb Ischemia Coding in ICD-10-CM (AAPC Approved 1.0 CEUs)

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New CLI/CLTI Coding Strategies for ICD-10-CM

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The CDC formally codified Critical Limb Ischemia/Chronic Limb-Threatening Ischemia as equivalent terms for 144 existing diagnosis codes. This means there are no newly created codes for CLI/CLTI, but there are 144 codes that can now be unambiguously and exclusively assigned for CLI/CLTI.

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All changes are found within category I70, Atherosclerosis, as shown in this excerpt:

  • 170 Atherosclerosis
    • 170.2 Atherosclerosis of native arteries of the extremities
      • 170.22 Atherosclerosis of native arteries of the extremities with rest pain
        • Add Includes: chronic limb-threatening ischemia NOS of native arteries of extremities
        • chronic limb-threatening ischemia of native arteries of extremities with rest pain
        • critical limb ischemia NOS of native arteries of extremities
        • critical limb ischemia of native arteries of extremities with rest pain
      • 170.23 Atherosclerosis of native arteries of right leg with ulceration
        • Add Includes: chronic limb-threatening ischemia of native arteries of right leg with ulceration
        • critical limb ischemia of native arteries of right leg with ulceration
      • 170.24 Atherosclerosis of native arteries of left leg with ulceration
        • Add Includes: chronic limb-threatening ischemia of native arteries of left leg with ulceration
        • critical limb ischemia of native arteries of left leg with ulceration
      • 170.26 Atherosclerosis of native arteries of extremities with gangrene
        • Add Includes: chronic limb-threatening ischemia of native arteries of extremities with gangrene
        • critical limb ischemia of native arteries of extremities with gangrene

These are code headings. To see the ICD-10-CM codes for CLI/CTLI in context, download the pdf go to pages 2-13.

The specific diagnosis code assigned depends on documentation of three factors:

  1. type of vessel:
    • native artery
    • bypass graft, unspecified
    • bypass graft, autologous vein
    • bypass graft, nonautologous biological
    • bypass graft, nonbiological
    • bypass graft, other

  1. manifestation:
    • rest pain
    • ulceration
    • gangrene
  2. location:
    • right leg
    • left leg
    • additional sites for ulceration

EHRs now recognize the terms “critical limb ischemia” and “chronic limb-threatening ischemia” when keyed in and will present code choices based on the three factors.

Note: ICD-10-CM does not recognize the abbreviations CLI and CLTI, key in full term.

The above applies across all places of service, including office, outpatient clinic, nursing facility, and hospital inpatient.

Resources

CLI C&M Proposal CLI DCD Approval