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Rutherford Classification 4 or ischemic rest pain or resting ankle pressure < 50 mmHg, flat or barely pulsatile ankle or metatarsal PVR or toe pressure < 40 mmHg
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Rutherford Classification 5 or minor tissue loss; non-healing ulcer, focal gangrene with diffuse pedal ischemia or resting ankle pressure < 50 mmHg, or flat or barely pulsatile ankle or metatarsal PVR, or toe pressure < 40 mmHg
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Rutherford Classification 6 or major tissue loss: extending above transmetatarsal level, functional foot no longer salvageable or resting ankle pressure < 50 mmHg, or flat or barely pulsatile ankle or metatarsal PVR, or toe pressure < 40 mmHg
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CLI related ICD 10 code (reason for admission or indication for procedure)
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Documentation of any of the following diagnostic evidence:
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i.
SPP < 50 mmHg
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ii.
TCPO2 < 50 mmHg
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iii.
Angiographic evidence no straight line to foot or>70% stenosis in all 3 lower extremity arteries (AT, PT, peroneal)
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iv.
ABI* ≤ 0.90
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v.
Non-compressible ABI ≥ 1.40 AND TBI ≤ 0.70
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vi.
TBI* ≤ 0.70
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