ICD-10 Coding for Venous Thromboembolism(I82.4, I26.9)
Complete ICD-10-CM coding and documentation guide for Venous Thromboembolism. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Venous Thromboembolism
I26-I28Primary Range
Pulmonary embolism and other pulmonary heart diseases
This range includes codes for pulmonary embolism, a major component of venous thromboembolism.
Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified
This range includes codes for deep vein thrombosis, another major component of venous thromboembolism.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I82.4 | Acute embolism and thrombosis of deep veins of lower extremity | Use for acute DVT confirmed by imaging in the lower extremity. |
|
| I26.9 | Pulmonary embolism without acute cor pulmonale | Use for confirmed pulmonary embolism 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 venous thromboembolism
Essential facts and insights about Venous Thromboembolism
Primary ICD-10-CM Codes for venous thromboembolism
Decision Criteria
clinical Criteria
- Presence of acute symptoms and positive imaging
documentation Criteria
- Explicit mention of 'acute' and specific vein
Applicable To
- Acute DVT of femoral vein
- Acute DVT of popliteal vein
Excludes
- Chronic DVT (I82.5)
Clinical Validation Requirements
- Positive Doppler ultrasound
- Clinical symptoms of swelling and pain
Code-Specific Risks
- Misclassification as chronic
- Omission of laterality
Coding Notes
- Ensure documentation specifies laterality and acuity.
I26.9 - Pulmonary embolism without acute cor pulmonale
Use for confirmed pulmonary embolism without acute cor pulmonale.
Applicable To
- Pulmonary embolism NOS
Excludes
- Pulmonary embolism with acute cor pulmonale (I26.0)
Clinical Validation Requirements
- CT pulmonary angiography showing embolism
- Symptoms of dyspnea and chest pain
Coding Notes
Ensure imaging confirms the diagnosis.
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 Thromboembolism to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I82.4.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Use templates that prompt for acuity, Educate providers on documentation standards
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always document and code the specific vein and laterality.
Impact
High risk of audit due to frequent coding errors.
Mitigation Strategy
Implement regular coding audits and provider education.
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 Thromboembolism, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Venous Thromboembolism
Use these documentation templates to ensure complete and accurate documentation for Venous Thromboembolism. These templates include all required elements for proper coding and billing.
Acute DVT diagnosis
Specialty: Internal MedicineRequired Elements
- Laterality
- Specific vein
- Diagnostic method
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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