Part 2 Peripheral Artery Disease and Atherosclerosis ICD-10-CM Codes

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Let us see two scenarios to understand the concept better.

Code E11.51 is used to identify diabetes mellitus with peripheral artery disease (PAD). Code I73.9 is used to identify PAD, peripheral vascular disease (PVD), and intermittent claudication. However, code I73.9 should not be used if the patient has diabetes mellitus and PAD. In this case, only code E11.51 should be used.

The reason for this is that code I73.9 is a general code that does not specify the underlying cause of PAD. Code E11.51, on the other hand, is a more specific code that identifies the underlying cause of PAD as diabetes mellitus. By using code E11.51, healthcare providers can ensure that patients with diabetes mellitus and PAD receive the appropriate treatment.

Here is an example of how to code a patient with diabetic PAD:

  • E11.51 Diabetes mellitus with peripheral artery disease.
  • The patient has diabetes mellitus and PAD.
  • Code I73.9 is not used because it is a general code that does not specify the underlying cause of PAD.
  • Code E11.51 is used because it is a more specific code that identifies the underlying cause of PAD as diabetes mellitus.

Scenario 1

A 65-year-old patient with type 2 diabetes mellitus presents with intermittent claudication in the right leg due to peripheral artery disease (PAD). The patient also has an ulcer on the right ankle.

Codes for Peripheral Vascular Disease (PVD)/Peripheral Artery Disease (PAD) and Diabetes:

  • E11.51 Diabetes mellitus with peripheral artery disease (PAD)
  • Note: The documentation should specify the type of diabetes mellitus.

Codes for Atherosclerosis/Arteriosclerosis:

  • I70.20 Atherosclerosis of native arteries of the extremities, unspecified, with intermittent claudication
  • Note: The documentation should specify the location (right leg) and specify "intermittent claudication."

L97.4 Non-pressure chronic ulcer of right ankle with necrosis of bone

Note: The documentation should specify the severity of the ulcer.

Note on Excludes 1:

When coding for atherosclerosis or arteriosclerosis, codes 173.9 and 170.2*-170.7* are excluded and should not be coded together.

In the context of coding, the term "EXCLUDES 1" indicates that the listed condition should not be coded together with the condition specified in the "excludes" note. It means that the two conditions cannot coexist in the same patient.

In this case, the code 173.8 represents "Other specified peripheral vascular diseases." The "EXCLUDES 1" note indicates that this code should not be used if the patient has diabetic (peripheral) angiopathy, which is coded under E08-E13 with .51-.52. It means that if the patient has diabetic angiopathy, you should use the appropriate code for diabetic angi opathy rather than code 173.8.

Scenario 2

ADMITTING DIAGNOSES: Diabetic wet gangrene of the foot - PAD (peripheral artery disease) 

DISCHARGE DIAGNOSES: - Diabetic wet gangrene of the foot - PAD (peripheral artery disease) - Amputation of fifth toe of left foot - Osteomyelitis of left foot.

HOSPITAL COURSE -- HOSPITAL COURSE: F admitted for diabetic L 5th toe cellulitis. Med DM II, htn, hld, obesity. diabetic L foot cellulitis - s/p L 5th digit amputation peripheral arterial disease -  mild troponin elevation: likely demand ischemia due to above - htn: controlled -  hypok: resolved.

Principal Diagnosis  

E1152 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene.

Secondary Diagnoses 

  • E871 Hypo-osmolality and hyponatremia
  • L03116 Cellulitis of left lower limb 
  • M869 Osteomyelitis, unspecified
  • I248 Other forms of acute ischemic heart disease
  • E1169 Type 2 diabetes mellitus with other specified complication
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