ICD-10 Coding for Venous Reflux(I87.2, I87.31)
Complete ICD-10-CM coding and documentation guide for Venous Reflux. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Venous Reflux
I87.2-I87.3Primary Range
Other specified and unspecified disorders of veins
This range includes codes for venous insufficiency and chronic venous hypertension, which are primary conditions associated with venous reflux.
Varicose veins of lower extremities
This range covers varicose veins, which can be associated with venous reflux when ulcers or inflammation are present.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
This range is used to specify the severity and location of ulcers associated with venous reflux.
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 | Venous insufficiency (chronic) (peripheral) | Use when venous insufficiency is documented without ulceration or inflammation. |
|
| I87.31 | Chronic venous hypertension (idiopathic) with ulcer | Use when venous hypertension is documented with associated ulceration. |
|
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 reflux
Essential facts and insights about Venous Reflux
Primary ICD-10-CM Codes for venous reflux
Decision Criteria
clinical Criteria
- Presence of venous reflux without ulceration
Applicable To
- Chronic venous insufficiency
Excludes
- Varicose veins of lower extremities (I83.-)
Clinical Validation Requirements
- Duplex ultrasound showing reflux duration >0.5 seconds in superficial veins
Code-Specific Risks
- Risk of undercoding if ulceration is present but not documented.
Coding Notes
- Ensure documentation supports the absence of ulceration or inflammation.
I87.31 - Chronic venous hypertension (idiopathic) with ulcer
Use when venous hypertension is documented with associated ulceration.
Applicable To
- Venous hypertension with ulcer
Excludes
- Varicose veins with ulcer (I83.0-)
Clinical Validation Requirements
- Duplex ultrasound confirming venous reflux with ulceration
Coding Notes
Link ulceration directly to venous hypertension.
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.-Differential 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 Venous Reflux to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I87.2.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure detailed ultrasound reports, Include reflux duration and vein diameter
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always specify laterality when coding venous conditions.
Impact
Reimbursement: Improper sequencing can affect DRG assignment., Compliance: Non-compliance with coding standards., Data Quality: Misleading clinical data.
Mitigation Strategy
Code the most specific condition first, such as venous hypertension with ulcer before general venous insufficiency.
Impact
Inadequate documentation of ulcer characteristics can lead to audit findings.
Mitigation Strategy
Ensure detailed documentation of ulcer size, depth, and response to treatment.
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 Reflux, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Venous Reflux
Use these documentation templates to ensure complete and accurate documentation for Venous Reflux. These templates include all required elements for proper coding and billing.
Chronic venous insufficiency with ulcer
Specialty: Vascular SurgeryRequired Elements
- Patient symptoms
- Ultrasound findings
- Ulcer characteristics
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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