I80.03 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupI80.03

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)

I80.03

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral

Inflammation and blood clot formation in the superficial veins affecting both legs.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I80Phlebitis and thrombophlebitis I80.0Phlebitis and thrombophlebitis of superficial vessels of lower extremities I80.03Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral

Inclusion Terms

Official

Phlebitis and thrombophlebitis of femoropopliteal veinInherited from I80.0

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from I00-I99
certain infectious and parasitic diseases (A00-B99)Inherited from I00-I99
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from I00-I99
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from I00-I99
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from I00-I99
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from I00-I99
neoplasms (C00-D49)Inherited from I00-I99
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from I00-I99
systemic connective tissue disorders (M30-M36)Inherited from I00-I99
transient cerebral ischemic attacks and related syndromes (G45.-)Inherited from I00-I99

Related Codes

Official

I80.00Phlebitis and thrombophlebitis of superficial vessels of unspecified lower extremity I80.01Phlebitis and thrombophlebitis of superficial vessels of right lower extremity I80.02Phlebitis and thrombophlebitis of superficial vessels of left lower extremity

Includes

Official

endophlebitisInherited from I80
inflammation, veinInherited from I80
periphlebitisInherited from I80
suppurative phlebitisInherited from I80

Excludes 1

Official

venous embolism and thrombosis of lower extremities (I82.4-, I82.5-, I82.81-)Inherited from I80

Code First

Official

, if applicable: phlebitis and thrombophlebitis complicating abortion, ectopic or molar pregnancy (O00-O07, O08.7)Inherited from I80
phlebitis and thrombophlebitis complicating pregnancy, childbirth and the puerperium (O22.-, O87.-)Inherited from I80

Use Additional

Official

No Use Additional Code instructions are included in this display for I80.03. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for I80.03. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Bilateral coding indicates involvement of both lower extremities

Ensure documentation clearly states bilateral involvement before assigning this code

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is I80.03 an HCC code?

No. I80.03 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: I80.03
Description: Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

I80.03 is the ICD-10-CM diagnosis code for phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral. Inflammation and blood clot formation in the superficial veins affecting both legs. I80.03 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (i80-i89).

I80.03 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Bilateral coding indicates involvement of both lower extremities.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I80.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Bilateral coding indicates involvement of both lower extremities
•Ensure documentation clearly states bilateral involvement before assigning this code