I82.431 Popliteal DVT: V28 HCC 267; Chronic Is I82.53-

If you searched right popliteal DVT ICD-10, I82.431, or chronic DVT ICD-10, here is the short answer. I82.431 (Acute embolism and thrombosis of right popliteal vein) is a billable code that maps to CMS-HCC V28 HCC 267 (Deep Vein Thrombosis and Pulmonary Embolism). The PY2026 V28 CSV on HCC Buddy main has the row `I82431,267.0,,,`, the V28 column of the CMS 2026 Final ICD-10-CM Mappings lists 267 for it, and the live card shows HCC 267.

The chronic code for the same vein, I82.531 (Chronic embolism and thrombosis of right popliteal vein), maps to HCC 267 too. So acute versus chronic does not change the V28 category. It still changes the code, and the code has to match what the provider wrote.

What does change the result is the step from an active clot to a past one. A personal history of DVT, Z86.718, has no V28 HCC, and neither does long-term anticoagulant use, Z79.01. Most of the audit risk in this cluster sits on that line.

The I82.4 and I82.5 codes, descriptors, and Tabular notes are the same in the FY2026 and FY2027 files, and the FY2027 Tabular addenda have no entries for them.

Desk table: popliteal DVT codes

I82.4, I82.43, I82.40, I82.5, and I82.53 are nonbillable headings, and the live cards say so. Pick a billable child code.

How the code is built

Every code in I82.4 (acute) and I82.5 (chronic) is built the same way. The fifth character names the vein and the sixth names the side.

• Fifth character, the vein. In the Alphabetic Index under Embolism, vein, femoral goes to I82.41-, iliac (iliofemoral) to I82.42-, popliteal to I82.43-, tibial to I82.44-, peroneal to I82.45-, and calf muscle, gastrocnemial, and soleal veins to I82.46-. I82.49- is for another specified deep vein, and I82.40- is for unspecified deep veins.
• Unspecified proximal or distal. The Index sends a deep vein of the thigh or upper leg to I82.4Y- and a deep vein of the calf or lower leg to I82.4Z-. Use these for an acute clot when the provider gives the level of the leg but not the vein. Each of those Index entries also has a chronic subterm. A chronic clot in a deep vein of the thigh or upper leg goes to I82.5Y- (Chronic embolism and thrombosis of unspecified deep veins of proximal lower extremity), and one in the calf or lower leg goes to I82.5Z- (Chronic embolism and thrombosis of unspecified deep veins of distal lower extremity). All eight billable codes in those two subcategories map to HCC 267, the same as the acute codes.
• Sixth character, the side. 1 is right, 2 is left, 3 is bilateral, and 9 is unspecified.

So an acute DVT the provider documents in the right popliteal vein is I82.431, and in the left, it is I82.432. If the provider calls the clot chronic, the codes are I82.531 for the right and I82.532 for the left. An acute clot in both popliteal veins is I82.433, and a chronic one is I82.533.

Section I.B.13 of the FY2027 guidelines covers the side: "If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side. If the side is not identified in the medical record, assign the code for the unspecified side." I82.43- and I82.53- each have a bilateral code, so an acute clot in both popliteal veins takes I82.433 and a chronic one takes I82.533, not two codes.

Name the vein when the note does

A few searches that land on these cards ask for a tibial or peroneal DVT. The Index has its own entries for both, so a named vein should not be coded to an unspecified distal code:

• I82.441 Acute embolism and thrombosis of right tibial vein. Category I82.44 lists the anterior and posterior tibial veins as inclusion terms.
• I82.451 Acute embolism and thrombosis of right peroneal vein.
• I82.461 Acute embolism and thrombosis of right calf muscular vein. Category I82.46 lists the gastrocnemial and soleal veins as inclusion terms.
• I82.4Z1 Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity. Subcategory I82.4Z lists a deep vein of the calf NOS and a deep vein of the lower leg NOS as inclusion terms.
• I82.4Y1 Acute embolism and thrombosis of unspecified deep veins of right proximal lower extremity. Subcategory I82.4Y lists a deep vein of the thigh NOS and a deep vein of the upper leg NOS as inclusion terms.

All of them map to HCC 267. The vein does not change the V28 category, so this is a precision point, not a capture point. An auditor still expects the code to match the vein named in the note.

Acute versus chronic

The Index entry is Embolism, vein (acute). The word "acute" is a nonessential modifier, and each vein has its own chronic subterm. Under popliteal, the entry is I82.43-, and the subterm chronic is I82.53-. The same pattern holds for the other veins. The chronic code needs the provider to call the clot chronic.

The Tabular has no definition of acute or chronic for these codes. That is the provider's call, so code the word the provider uses. When a note says "DVT" with no acuity and the plan reads like a long-standing clot, ask the provider rather than picking one.

Both columns land in the same place under V28. I82.431 and I82.531 each have one row with CC 267.0, as do the left, bilateral, and unspecified popliteal codes.

DVT NOS and "thrombosis" with no vein

I82.40- is the subcategory for unspecified deep veins of the leg, and it lists "Deep vein thrombosis NOS" and "DVT NOS" as inclusion terms. The sixth character still gives the side, and I82.409 (Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity) is the code when the side is not documented either. It maps to HCC 267. I82.40 has an Excludes1 note for the unspecified distal (I82.4Z-) and proximal (I82.4Y-) codes, so when the provider gives the calf or the thigh, those codes are used instead.

The word "deep" matters. The Index main term Thrombosis with no further detail goes to I82.90, and so does Thrombosis, vein (acute). I82.90 (Acute embolism and thrombosis of unspecified vein) has the inclusion terms "Embolism of vein NOS" and "Thrombosis (vein) NOS". It has no CSV row and no V28 HCC. A note that says only "leg clot" or "venous thrombosis" does not tell you it is a deep vein. Ask before you code it as a DVT.

Superficial is not deep

The Index sends a superficial vein of the leg, and the greater or lesser saphenous vein, to I82.81-. I82.811 (Embolism and thrombosis of superficial veins of right lower extremity) has no CSV row and no V28 HCC. A superficial clot in the saphenous vein is not coded as a DVT.

Category I80 Phlebitis and thrombophlebitis has an Excludes1 note for "venous embolism and thrombosis of lower extremities (I82.4-, I82.5-, I82.81-)". Section I.A.12.a says an Excludes1 note "indicates that the code excluded should never be used at the same time as the code above the Excludes1 note." So the same clot is not coded with both an I80 code and an I82 code. For thrombophlebitis of the popliteal vein, the Index sends Phlebitis, leg, deep, popliteal vein to I80.22-, and I80.221 also maps to HCC 267.

The CSV rows behind the answer

Each code has one row in the PY2026 V28 CSV, with no age or sex condition:

• `I82431,267.0,,,`
• `I82432,267.0,,,`
• `I82433,267.0,,,`
• `I82439,267.0,,,`
• `I82531,267.0,,,`
• `I82532,267.0,,,`
• `I82533,267.0,,,`
• `I82539,267.0,,,`
• `I82409,267.0,,,`
• `I824Z1,267.0,,,`
• `I82441,267.0,,,`

The columns are ICD10, CC, MCE_AGE_CONDITION, AGE_EDIT_CONDITION, and SEX_EDIT_CONDITION. There is no row for I82811, I8290, Z86718, or Z7901.

The CMS 2026 Final ICD-10-CM Mappings agree. They list V28 category 267 for I82.431, I82.432, I82.433, I82.439, I82.531, I82.532, I82.533, and I82.539. This post covers the CMS-HCC V28 result only.

Where HCC 267 sits

In the V28 hierarchy file, the row for HCC 267 is `HCC267,,,,,,`. It lists no lower category, and no other row lists HCC 267. So HCC 267 does not supersede another category, and no category supersedes it.

The PY2026 V28 relative factors list HCC 267 with a CNA reference of 0.294 and a COMMUNITY_ND value of 0.431. These are community segment values, not member totals, and the segment a member is scored in depends on that member's enrollment data.

The live HCC 267 hub lists 167 codes, and that count matches the CSV.

Pulmonary embolism with a DVT

Category I82 has an Excludes2 note for "venous embolism and thrombosis (of):", and one of the entries it lists is "pulmonary (I26.-)". Section I.A.12.b says that "When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate." So a DVT and a pulmonary embolism the provider documents at the same time are both coded. I26.99 (Other pulmonary embolism without acute cor pulmonale) maps to HCC 267 as well, so both codes fall into the same V28 category.

Chronic DVT, anticoagulants, and history

Subcategory I82.5 carries two notes that matter for risk adjustment:

• A use additional code note for "associated long-term (current) use of anticoagulants (Z79.01)", if applicable.
• An Excludes1 note for "personal history of venous embolism and thrombosis (Z86.718)".

Section I.C.21.c.3 explains the anticoagulant code: "Assign a code from Z79 if the patient is receiving a medication for an extended period as a prophylactic measure (such as for the prevention of deep vein thrombosis) or as treatment of a chronic condition (such as arthritis) or a disease requiring a lengthy course of treatment (such as cancer)." Z79.01 has no V28 HCC. It describes the drug, not the clot.

Section I.C.21.c.4 explains the history code: "Personal history codes explain a patient's past medical condition that no longer exists and is not receiving any treatment, but that has the potential for recurrence, and therefore may require continued monitoring." The Index sends Thrombosis, personal history (of) to Z86.718, which has no V28 HCC. Because of the I82.5 Excludes1 note, Z86.718 and a chronic DVT code for the same clot are not reported together. Section I.A.12.a makes one exception: "An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider."

So the provider's words decide it:

• If the provider documents a current clot, acute or chronic, and is managing it, the I82.4 or I82.5 code is supported. Add Z79.01 when the patient is on long-term anticoagulation.
• If the provider documents that the clot is resolved and the patient is no longer being treated for it, Z86.718 fits, and it does not map.
• If the note says "history of DVT" while the plan shows ongoing anticoagulation for a clot the provider still treats as present, the two do not line up. Ask the provider whether the clot is current, chronic, or resolved.

Neighbors coders mix up

Popliteal artery, not vein. A clot in the popliteal artery is not a DVT. The Index sends Thrombosis, leg, arterial to I74.3, which maps to HCC 264 (Vascular Disease with Complications), a different category with a CNA reference of 0.455.

Postthrombotic syndrome. I87.0 Postthrombotic syndrome includes "Chronic venous hypertension due to deep vein thrombosis" and "Postphlebitic syndrome". It is a separate condition from the clot itself. I87.001, without complications, has no V28 HCC. I87.011, with ulcer, maps to HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle).

MEAT for a DVT code

For I82.431, I82.531, and the other I82.4 and I82.5 codes, the note should support the clot as a current condition the provider is managing, not just a line in the past history:

• M Monitor: the course of the clot as the provider follows it at this visit
• E Evaluate: the imaging or other results the provider reviewed for it
• A Assess: the DVT named as current, with the vein, the side, and acute or chronic
• T Treat: the anticoagulation, referral, or other plan the provider documents for it

MEAT is a review mnemonic, not a universal CMS coding rule. Follow the applicable coding, encounter, program, and payer requirements. See MEAT.

Reporting rules that apply

Section IV.H says not to code diagnoses documented as "probable", "suspected," "questionable," "rule out," "compatible with," "consistent with," or "working diagnosis" or other similar terms indicating uncertainty, and to code "the condition(s) to the highest degree of certainty for that encounter/visit, such as symptoms, signs, abnormal test results, or other reason for the visit." A "rule out DVT" order in an office note is not coded as I82.4-. Code what the provider has confirmed, or the symptoms and findings they document.

Audit and query traps

1. Coding a DVT from a "rule out DVT" order or a pending ultrasound. Section IV.H does not allow it in the outpatient setting.

2. Coding I82.90 or "thrombosis NOS" as a DVT. The Index sends thrombosis with no vein to I82.90, which has no V28 HCC. Ask whether it is a deep vein.

3. Coding a saphenous or superficial clot as a DVT. That is I82.81-, with no V28 HCC.

4. Coding a named tibial or peroneal vein to I82.4Z-. The Index has I82.44- and I82.45- for them.

5. Choosing the chronic code without the provider's word "chronic".

6. Reporting Z86.718 with a chronic DVT code for the same clot. The I82.5 Excludes1 note does not allow it unless the two conditions are unrelated, and an unclear relationship is a query.

7. Carrying an acute DVT code forward after the provider documents the clot as resolved and treatment as finished. That is Z86.718, which does not map.

8. Treating Z79.01 as if it proves a current DVT. It describes the drug, and it has no V28 HCC.

9. Coding a popliteal artery clot to I82.43-. Arterial leg thrombosis is I74.3, HCC 264.

10. Using a CNA reference as a member RAF total, or inventing Coding Clinic quotes, competitor comparisons, or PHI examples.

Two-minute check

1. Does the provider document a deep vein, by name or by level (thigh, calf)?

2. Which vein and which side? Popliteal is I82.43- (acute) or I82.53- (chronic); 1 is right, 2 is left, 3 is bilateral.

3. Does the provider call it acute, chronic, or resolved?

4. Is it current and managed at this visit, or documented as past with no current treatment?

5. Add Z79.01 when the patient is on long-term anticoagulation, and do not pair Z86.718 with a chronic DVT code unless the provider documents the two as unrelated.

6. Expect HCC 267 for every I82.4, I82.5, and I26 code in this desk, no V28 HCC for I82.81-, I82.90, Z86.718, or Z79.01, and HCC 264 for an arterial clot.

7. Confirm the map on the live card and the CSV row. Confirm MEAT for this year.

Related desks and tools

• Live cards: I82.431, I82.432, I82.433, I82.531, I82.532, I82.4Z1, I82.441, I82.811, Z86.718, Z79.01
• Hubs: HCC 267, HCC 264
• Lookup: ICD-10 to HCC, Encoder
• Evidence habits: MEAT, provider query templates, acute vs history of, hierarchy and trumping rules
• Nearby: excludes 1 vs excludes 2, codes that do not map, status Z codes that map, FY2027 code changes

Sources

• Live HCC Buddy ICD-10-CM cards (FY2027 Tabular display) and the V28 HCC 267 and HCC 264 hubs, fetched November 5, 2026
• FY2026 and FY2027 ICD-10-CM order file billable flags, the FY2026 and FY2027 Tabular, the FY2027 Alphabetic Index, and the FY2027 Tabular and Index addenda
• CMS, FY2027 ICD-10-CM Official Guidelines for Coding and Reporting, Sections I.A.12.a, I.A.12.b, I.B.13, I.C.21.c.3, I.C.21.c.4, and IV.H
• PY2026 V28 mapping, hierarchy, and relative factor files on HCC Buddy main
• CMS, ICD-10 codes (FY2027 ICD-10-CM code files and addendum, effective October 1, 2026)
• CMS, 2026 Model Software/ICD-10 Mappings (PY2026 V28 mappings, hierarchies, relative factors, and the 2026 Final ICD-10-CM Mappings)

V28 mappings come from the cited live code pages and the PY2026 V28 CSV. Coefficients are source-labeled references, not member totals. Not medical advice. Not a Coding Clinic reprint.

Current as of November 5, 2026. Always confirm the V28 mapping for the payment year you are scoring and the live code card before you lock a map claim. The map claims here come from the PY2026 V28 CSV. For PY2027 scores, use the PY2027 V28 mapping. The PY2027 initial V28 CSV on HCC Buddy main has the same category for every code in this post.