I82.423

HCC Category Mapping

What This Code Means

A blood clot that suddenly forms in both pelvic veins (iliac veins), blocking blood flow in both lower abdomen and legs.

Coding Tips

• •Only assign when bilateral iliac vein thrombosis is explicitly documented
• •Verify this is not a case of unilateral thrombosis that was miscoded

Clinical Significance

Acute iliac vein thrombosis is a proximal deep vein thrombosis involving the pelvic veins, carrying the highest risk of pulmonary embolism among lower extremity deep vein thrombosis. These patients often require aggressive intervention including catheter-directed thrombolysis, IVC filter consideration, and intensive anticoagulation. This diagnosis reflects critical vascular disease severity important for accurate risk stratification.

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