I80.259
BillablePhlebitis and thrombophlebitis of unspecified calf muscular vein
HCC Category Mapping
V28HCC 267 — Vascular Disease
0.356V24HCC 108 — Vascular Disease
0.297ESRDHCC 108 — Vascular Disease
0.000RxHCCHCC 215 — Pulmonary Embolism and Other Vascular Disease
0.000What This Code Means
Inflammation and blood clot formation in the deep calf muscle veins when the specific side (left or right) is not documented or specified.
Coding Tips
- •Use only when laterality cannot be determined from documentation; query provider if possible for more specific coding
- •This is a less specific code and should be avoided if any documentation indicates which leg is affected
Clinical Significance
Deep vein thrombophlebitis of the lower extremity involves both inflammation and clot formation in the deep venous system, carrying risk of clot propagation and pulmonary embolism. This condition requires anticoagulation therapy and ongoing vascular monitoring, reflecting significant resource utilization. Accurate coding is essential for risk adjustment as it indicates chronic vascular disease burden requiring sustained medical management.
Documentation Requirements
- ✓Clinical diagnosis of venous thrombosis or thrombophlebitis clearly documented by the treating provider
- ✓Diagnostic confirmation via duplex ultrasonography, CT venography, MR venography, or venography with imaging findings described
- ✓Current treatment plan including anticoagulation regimen with specific medication, dose, and duration
- ✓Laterality documentation should be sought; if unavailable, document the reason laterality cannot be determined
- ✓Documentation distinguishing deep vein thrombophlebitis from superficial thrombophlebitis
- ✓Assessment of risk factors (immobility, recent surgery, malignancy, hypercoagulable state, oral contraceptive use)
Commonly Confused Codes
I80.10-I80.13 — Phlebitis of femoral vein; use when specifically the femoral vein is involved rather than other deep calf vesselsI80.20-I80.209 — Phlebitis of unspecified deep vessels; less specific codes that do not identify the particular deep vein involvedI82.40x-I82.4Zx — Acute embolism and thrombosis of deep veins of lower extremity; use for acute DVT without the inflammatory phlebitis componentI80.0- — Phlebitis of superficial vessels of lower extremities; use for superficial vein involvement rather than deep veinsI87.01x — Postthrombotic syndrome; use for chronic sequelae of prior DVT, not active thrombophlebitis
Code Hierarchy
└I80Phlebitis and thrombophlebitis└I80.2Phlebitis and thrombophlebitis of other and unspecified deep vessels of lower extremities└I80.25Phlebitis and thrombophlebitis of calf muscular vein└I80.259Phlebitis and thrombophlebitis of unspecified calf muscular vein
└I80.259Phlebitis and thrombophlebitis of unspecified calf muscular vein