What is ICD-10 code I82.211?

I82.211 is the ICD-10-CM diagnosis code for Chronic embolism and thrombosis of superior vena cava. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I82.211 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I82.211 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I82.211 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I82.211 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does I82.211 map to under V28?

I82.211 maps to CMS-HCC V28 267 (Deep Vein Thrombosis and Pulmonary Embolism). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does I82.211 pay in RAF?

I82.211 carries a community, non-dual, aged (CNA) RAF weight of 0.294 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for I82.211?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For I82.211, V28 maps to Deep Vein Thrombosis and Pulmonary Embolism at RAF 0.294 while V24 mapped to Vascular Disease at RAF 0.288. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports I82.211?

Verify documentation specifies 'chronic' status; acute thrombosis of the superior vena cava uses different codes (I82.210) Look for associated conditions such as malignancy, central venous catheters, or hypercoagulable states that may require additional coding Because I82.211 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM I82.211: Chronic embolism

I82.211 maps to CMS-HCC V28 267 (RAF 0.294). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

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Code lookupI82.211Effective 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)

I82.211

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

Chronic embolism and thrombosis of superior vena cava

A blood clot that has formed in the superior vena cava (the large vein that returns blood from the upper body to the heart) and has persisted over time. This chronic condition can restrict blood flow from the upper body and may cause swelling in the arms, neck, and face.

Buddy Insight

Chronic superior vena cava thrombosis reflects long-standing venous obstruction that may cause persistent upper body edema and collateral vein development.

CMS-HCC V28

Mapped

HCC 267

Deep Vein Thrombosis and Pulm...

RAF 0.294

CMS-HCC V24

Mapped

HCC 108

Vascular Disease

RAF 0.288

ACA/HHS

Mapped

HCC 156

HHS-HCC 156

Varies by metal level

ESRD/PACE

Mapped

HCC 108

Vascular Disease

RAF 0.073

RXHCC

Mapped

HCC 215

Pulmonary Embolism and Other ...

RAF 0.228

Code Book Path

Official

I82.2Embolism and thrombosis of vena cava and other thoracic veins

I82.21Embolism and thrombosis of superior vena cava

I82.211Chronic embolism and thrombosis of superior vena cava

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I82.211 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I82.211 in this effective period.

Related Child Codes

Official

I82.210Acute embolism and thrombosis of superior vena cava

Includes

Official

ICD-10-CM does not list Includes notes for I82.211 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I82.211 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I82.211 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I82.211 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I82.211 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

Documentation of chronic or long-standing nature of the thrombosis, including original date of diagnosis if available

MEAT Support

HCC Buddy guidance

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

Documentation of chronic or long-standing nature of the thrombosis, including original date of diagnosis if available

Audit Caution

HCC Buddy guidance

Assigning a chronic code when the thrombosis is actually a new acute event; always verify the provider's documentation of chronicity

Failing to assign a separate code for pulmonary embolism (I26.-) when documented as a complication of the deep vein thrombosis

Not coding current anticoagulant therapy status (Z79.01) or history of venous thromboembolism (Z86.718) as additional diagnoses when applicable

Common Mistakes

HCC Buddy guidance

I82.220/I82.221 — Inferior vena cava thrombosis; involves the IVC returning blood from the lower body, not the SVC

I87.1 — Compression of vein; use for external compression rather than intrinsic thrombosis

I82.290/I82.291 — Thrombosis of other thoracic veins; use for thoracic veins other than the SVC

I82.0 — Budd-Chiari syndrome; involves hepatic veins specifically, not the SVC

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 I82.211 an HCC code?

Yes. I82.211 (Chronic embolism and thrombosis of superior vena cava) maps to Deep Vein Thrombosis and Pulmonary Embolism under the CMS-HCC V28 risk adjustment model (and Vascular Disease under V24), with a community non-dual aged RAF of 0.294. It is billable for payment year 2026.

Coder answer: I82.211 is billable and maps to V28 HCC 267, Deep Vein Thrombosis and Pulmonary Embolism. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: I82.211
Description: Chronic embolism and thrombosis of superior vena cava
HCC (V28): HCC 267 — Deep Vein Thrombosis and Pulmonary Embolism
RAF: 0.294
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 267, Deep Vein Thrombosis and Pulmonary Embolism

0.294

V24HCC 108, Vascular Disease

0.288

ESRDHCC 108, Vascular Disease

0.073

RxHCCHCC 215, Pulmonary Embolism and Other Vascular Disease

0.228

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work I82.211 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I82.211

For I82.211 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I82.211 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I82.211 is the ICD-10-CM diagnosis code for chronic embolism and thrombosis of superior vena cava. A blood clot that has formed in the superior vena cava (the large vein that returns blood from the upper body to the heart) and has persisted over time. This chronic condition can restrict blood flow from the upper body and may cause swelling in the arms, neck, and face. I82.211 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).

Under the CMS-HCC V28 risk adjustment model, I82.211 maps to Deep Vein Thrombosis and Pulmonary Embolism (HCC 267) with a community, non-dual, aged base RAF weight of 0.294. Under the older CMS-HCC V24 model, I82.211 maps to Vascular Disease (HCC 108) with a community, non-dual, aged base RAF weight of 0.288. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Verify documentation specifies 'chronic' status; acute thrombosis of the superior vena cava uses different codes (I82.210). Because I82.211 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I82.211 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation specifies 'chronic' status; acute thrombosis of the superior vena cava uses different codes (I82.210)
•Look for associated conditions such as malignancy, central venous catheters, or hypercoagulable states that may require additional coding

Clinical Significance

Chronic superior vena cava thrombosis reflects long-standing venous obstruction that may cause persistent upper body edema and collateral vein development. It typically indicates ongoing management with anticoagulation and monitoring for complications such as recurrent thrombosis or post-thrombotic syndrome. Accurate coding captures the sustained resource utilization these patients require.

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
✓Documentation of chronic or long-standing nature of the thrombosis, including original date of diagnosis if available
✓Documentation of any associated central venous devices, malignancy, or precipitating factors
✓Assessment of superior vena cava syndrome symptoms (facial/upper extremity edema, dyspnea, venous distension)

Commonly Confused Codes

•I82.220/I82.221: Inferior vena cava thrombosis; involves the IVC returning blood from the lower body, not the SVC
•I87.1: Compression of vein; use for external compression rather than intrinsic thrombosis
•I82.290/I82.291: Thrombosis of other thoracic veins; use for thoracic veins other than the SVC
•I82.0: Budd-Chiari syndrome; involves hepatic veins specifically, not the SVC
•I82.210: Acute SVC thrombosis; verify acute vs. chronic status carefully