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ICD-10-CM code changes for Critical Limb Ischemia/Chronic Limb-Threatening Ischemia

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.

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.

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