ICD-10 Coding for Venous Thrombosis(I82.401, I26.99)
Complete ICD-10-CM coding and documentation guide for Venous Thrombosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Venous Thrombosis
I82.4-I82.5Primary Range
Acute and chronic venous embolism and thrombosis of lower extremities
This range includes codes for acute and chronic DVT, which are the primary conditions under venous thrombosis.
Other pulmonary embolism without acute cor pulmonale
Used when pulmonary embolism is present alongside DVT, often as a primary diagnosis.
Personal history of other venous thrombosis and embolism
Used for patients with a history of resolved venous thrombosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I82.401 | Acute embolism and thrombosis of unspecified deep veins of right lower extremity | Use when acute DVT is confirmed in the right lower extremity without specific vein identification. |
|
| I26.99 | Other pulmonary embolism without acute cor pulmonale | Use when PE is confirmed and is the primary reason for admission. |
|
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 thrombosis
Essential facts and insights about Venous Thrombosis
Primary ICD-10-CM Codes for venous thrombosis
Decision Criteria
clinical Criteria
- Presence of acute symptoms and imaging confirmation
documentation Criteria
- Specificity in laterality and vein affected
Applicable To
- Acute DVT of right lower extremity
Excludes
- Chronic DVT
Clinical Validation Requirements
- Doppler ultrasound confirming clot
- Symptoms such as swelling and pain
Code-Specific Risks
- Risk of unspecified coding if laterality or specific vein is not documented.
Coding Notes
- Ensure documentation specifies 'acute' and the affected side.
I26.99 - Other pulmonary embolism without acute cor pulmonale
Use when PE is confirmed and is the primary reason for admission.
Applicable To
- Pulmonary embolism without acute cor pulmonale
Excludes
- Pulmonary embolism with acute cor pulmonale
Clinical Validation Requirements
- CT angiography confirming PE
- Symptoms such as dyspnea and chest pain
Coding Notes
Ensure PE is documented as the primary condition if it is the main reason for admission.
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 Venous Thrombosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I82.401.
Impact
Clinical: Leads to unspecified coding, affecting treatment decisions., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential for reduced reimbursement due to unspecified codes.
Mitigation Strategy
Always document the side of the body affected., Use templates that prompt for laterality.
Impact
Reimbursement: May affect DRG assignment and reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data affecting patient records and statistics.
Mitigation Strategy
Verify the acuity of the condition through documentation and imaging.
Impact
Use of unspecified codes can trigger audits due to lack of specificity.
Mitigation Strategy
Ensure documentation includes all required details such as laterality and acuity.
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 Thrombosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Venous Thrombosis
Use these documentation templates to ensure complete and accurate documentation for Venous Thrombosis. These templates include all required elements for proper coding and billing.
Acute DVT with PE
Specialty: CardiologyRequired Elements
- Onset date
- Symptoms
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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