ICD-10 Coding for Venous Insufficiency(I87.2, L97.-)
Complete ICD-10-CM coding and documentation guide for Venous Insufficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Venous Insufficiency
I87.2Primary Range
Chronic venous insufficiency (CVI) of extremities
Primary code for diagnosing chronic venous insufficiency.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Used when ulcers are present due to venous insufficiency.
Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
Used when venous insufficiency is related to diabetic conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I87.2 | Chronic venous insufficiency (CVI) of extremities | Use when chronic venous insufficiency is confirmed by clinical findings and Doppler studies. |
|
| L97.- | Non-pressure chronic ulcer of lower limb, not elsewhere classified | Use when ulcers are present and related to venous insufficiency. |
|
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 venous insufficiency
Essential facts and insights about Venous Insufficiency
Primary ICD-10-CM Codes for venous insufficiency
Decision Criteria
clinical Criteria
- Presence of edema, skin changes, and confirmed venous reflux
Applicable To
- Chronic venous stasis
Excludes
- Varicose veins of lower extremities (I83.-)
Clinical Validation Requirements
- Doppler ultrasound showing reflux >0.5 seconds
- Chronicity of symptoms >3 months
Code-Specific Risks
- Incorrectly coding without confirming chronicity
- Confusing with acute venous conditions
Coding Notes
- Ensure documentation specifies chronicity and confirms venous origin through diagnostic testing.
L97.- - Non-pressure chronic ulcer of lower limb, not elsewhere classified
Use when ulcers are present and related to venous insufficiency.
Applicable To
- Venous stasis ulcer
Excludes
- Pressure ulcer (L89.-)
Clinical Validation Requirements
- Documentation of ulcer location, depth, and venous etiology
Coding Notes
Ensure ulcer documentation includes specific location and depth.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
L97.-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Venous Insufficiency to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I87.2.
Impact
Clinical: Inadequate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use templates to ensure all necessary details are documented, Regular training on documentation standards
Impact
Reimbursement: May lead to denied claims if chronicity is not documented., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient condition.
Mitigation Strategy
Ensure documentation includes chronic symptoms and diagnostic confirmation.
Impact
Failure to document chronicity can lead to audit issues.
Mitigation Strategy
Implement checklist for chronic conditions documentation.
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 Venous Insufficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Venous Insufficiency
Use these documentation templates to ensure complete and accurate documentation for Venous Insufficiency. These templates include all required elements for proper coding and billing.
Chronic Venous Insufficiency with Ulcer
Specialty: Vascular SurgeryRequired Elements
- History of symptoms and duration
- Physical examination findings
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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