I82.403 ICD-10-CM Code: Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)
I82.403
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral
A blood clot has suddenly formed in the deep veins of both legs. This is a serious condition where blood flow is blocked in the major veins beneath the skin on both sides of the body.

Buddy Insight
Acute deep vein thrombosis of the lower extremity is a serious vascular condition carrying risk of pulmonary embolism if the clot dislodges and travels to the lungs.
CMS-HCC V28
MappedHCC 267
RAF 0.294
CMS-HCC V24
MappedHCC 108
RAF 0.288
ACA/HHS
MappedHCC 156
Varies by metal level
ESRD/PACE
MappedHCC 108
RAF 0.073
RXHCC
MappedHCC 215
RAF 0.228
Code Book Path
Inclusion Terms
Official- Deep vein thrombosis NOS
- DVT NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I82.403 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I82.403 in this effective period.
Excludes 1
Official- acute embolism and thrombosis of unspecified deep veins of distal lower extremity (I82.4Z-)
- acute embolism and thrombosis of unspecified deep veins of proximal lower extremity (I82.4Y-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I82.403 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for I82.403 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for I82.403 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 I82.403 an HCC code?
Yes. I82.403 (Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral) 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: I82.403 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
- I82.403
- Description
- Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral
- HCC (V28)
- HCC 267 — Deep Vein Thrombosis and Pulmonary Embolism
- RAF
- 0.294
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 I82.403 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for I82.403
For I82.403 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 I82.403 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
I82.403 is the ICD-10-CM diagnosis code for acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral. A blood clot has suddenly formed in the deep veins of both legs. This is a serious condition where blood flow is blocked in the major veins beneath the skin on both sides of the body. I82.403 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, I82.403 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, I82.403 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 'bilateral' involvement of both lower extremities before assigning this code; if only one leg is affected, use a more specific unilateral code instead. Because I82.403 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 I82.403 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies 'bilateral' involvement of both lower extremities before assigning this code; if only one leg is affected, use a more specific unilateral code instead
- •Ensure the clinical record documents this as 'acute' rather than chronic; acute indicates sudden onset within the current episode of care
Clinical Significance
Acute deep vein thrombosis of the lower extremity is a serious vascular condition carrying risk of pulmonary embolism if the clot dislodges and travels to the lungs. These patients require urgent anticoagulation therapy and ongoing monitoring to prevent clot extension and recurrence. Accurate coding ensures proper risk adjustment reflecting the acute care needs and chronic vascular disease burden.
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 acute onset with date of symptom onset or diagnosis establishing the acute nature
- ✓Explicit documentation that both lower extremities are affected
- ✓Assessment of risk factors (immobility, recent surgery, malignancy, hypercoagulable state, oral contraceptive use)
Commonly Confused Codes
- •I82.411-I82.419: Femoral vein thrombosis; use when specific vein is identified as femoral
- •I82.431-I82.439: Popliteal vein thrombosis; use when specific vein is identified as popliteal
- •I82.441-I82.449: Tibial vein thrombosis; use when specific vein is identified as tibial
- •I80.20-I80.29: Phlebitis and thrombophlebitis of deep vessels; use when inflammatory component is present
- •I82.401-I82.409: Acute DVT of unspecified deep veins; less specific than other specified codes

