ICD-10 Coding for Blood Clot(I82.411, I26.90)
Complete ICD-10-CM coding and documentation guide for Blood Clot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Blood Clot
I82.4-I82.5Primary Range
Acute and chronic venous embolism and thrombosis
This range covers the primary ICD-10 codes for deep vein thrombosis (DVT) and related conditions.
Pulmonary embolism
This range includes codes for pulmonary embolism, a common complication of DVT.
Other thrombophilia
This range is used for coding hypercoagulable states that may lead to 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 |
|---|---|---|---|
| I82.411 | Acute embolism and thrombosis of right femoral vein | Use when acute DVT is confirmed in the right femoral vein. |
|
| I26.90 | Pulmonary embolism without acute cor pulmonale | Use when PE is confirmed without acute cor pulmonale. |
|
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 acute blood clot
Essential facts and insights about Blood Clot
Primary ICD-10-CM Codes for blood clot
Decision Criteria
clinical Criteria
- Presence of acute symptoms and diagnostic confirmation
Applicable To
- Acute DVT of right femoral vein
Excludes
- Chronic embolism and thrombosis of right femoral vein (I82.511)
Clinical Validation Requirements
- Doppler ultrasound confirmation
- Clinical symptoms such as unilateral leg swelling
Code-Specific Risks
- Misclassification as chronic if not specified as acute
Coding Notes
- Ensure documentation specifies 'acute' to avoid incorrect coding.
I26.90 - Pulmonary embolism without acute cor pulmonale
Use when PE is confirmed without acute cor pulmonale.
Applicable To
- PE without acute cor pulmonale
Excludes
- Pulmonary embolism with acute cor pulmonale (I26.01)
Clinical Validation Requirements
- CT angiography showing pulmonary artery filling defect
- Elevated D-dimer levels
Coding Notes
Ensure cor pulmonale status is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 Blood Clot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I82.411.
Impact
Clinical: Impacts treatment decisions and follow-up care., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Always document the side of the body affected., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Code as acute if it is a new thrombus.
Impact
Failure to document anticoagulant use can lead to audit discrepancies.
Mitigation Strategy
Implement checklist for anticoagulant documentation in patient records.
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 Blood Clot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Blood Clot
Use these documentation templates to ensure complete and accurate documentation for Blood Clot. These templates include all required elements for proper coding and billing.
Acute DVT in Emergency Department
Specialty: Emergency MedicineRequired Elements
- Acuity
- Location
- Diagnostic confirmation
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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