ICD-10 Coding for Thromboembolism(I26.01, I82.401)
Complete ICD-10-CM coding and documentation guide for Thromboembolism. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Thromboembolism
I26-I28Primary Range
Pulmonary embolism and other pulmonary heart diseases
This range includes codes for pulmonary embolism, a common form of thromboembolism.
I80-I82Primary Range
Phlebitis and thrombophlebitis, other venous embolism and thrombosis
This range covers deep vein thrombosis (DVT) and other venous thromboembolic events.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I26.01 | Acute pulmonary embolism with cor pulmonale | Use when acute PE is confirmed with right heart strain. |
|
| I82.401 | Acute embolism and thrombosis of unspecified deep veins of right lower extremity | Use when acute DVT is confirmed in the right leg. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for thromboembolism
Essential facts and insights about Thromboembolism
Primary ICD-10-CM Codes for thromboembolism
Decision Criteria
clinical Criteria
- Presence of right heart strain on echocardiogram
Applicable To
- Acute PE with right heart strain
Excludes
- Chronic pulmonary embolism (I27.82)
Clinical Validation Requirements
- CT angiography showing PE
- Echocardiogram indicating right ventricular strain
Code-Specific Risks
- Misclassification without echocardiogram confirmation
Coding Notes
- Ensure documentation specifies right heart strain for accurate coding.
I82.401 - Acute embolism and thrombosis of unspecified deep veins of right lower extremity
Use when acute DVT is confirmed in the right leg.
Applicable To
- Acute DVT of right leg
Excludes
- Chronic embolism and thrombosis (I82.501)
Clinical Validation Requirements
- Doppler ultrasound confirming DVT
Coding Notes
Ensure laterality is documented clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of anticoagulants
Z79.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Thromboembolism to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I26.01.
Impact
Clinical: Inaccurate treatment records, Regulatory: Non-compliance with coding standards, Financial: Potential reimbursement denial
Mitigation Strategy
Review medication list, Include in discharge summary
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Potential audit flags for incorrect coding., Data Quality: Skewed clinical data affecting patient care decisions.
Mitigation Strategy
Verify duration and symptoms to distinguish between acute and chronic.
Impact
Misclassification of acute vs. chronic DVT
Mitigation Strategy
Regular training on documentation requirements
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Thromboembolism, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Thromboembolism
Use these documentation templates to ensure complete and accurate documentation for Thromboembolism. These templates include all required elements for proper coding and billing.
Acute DVT diagnosis
Specialty: CardiologyRequired Elements
- Patient history
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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