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I82.441 ICD-10-CM Code: Acute embolism and thrombosis of right tibial vein

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

I82.441

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

Acute embolism and thrombosis of right tibial vein

A blood clot that suddenly forms in the right tibial vein (the larger vein in the lower leg below the knee), blocking blood flow.

Buddy the Bee presenting code insight

Buddy Insight

Acute tibial vein thrombosis is a distal deep vein thrombosis in the lower leg that, while generally carrying lower pulmonary embolism risk than proximal clots, still requires treatment to prevent proximal extension.

CMS-HCC V28

HCC 267

RAF 0.294

CMS-HCC V24

HCC 108

RAF 0.288

ACA/HHS

HCC 156

Varies by metal level

ESRD/PACE

HCC 108

RAF 0.073

RXHCC

HCC 215

RAF 0.228

Code Book Path

Official
I82.4Acute embolism and thrombosis of deep veins of lower extremity
I82.44Acute embolism and thrombosis of tibial vein
I82.441Acute embolism and thrombosis of right tibial vein

Inclusion Terms

Official
  • Acute embolism and thrombosis of anterior tibial vein
  • Acute embolism and thrombosis of posterior tibial vein

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I82.441 in this effective period.

Related Child Codes

Official
I82.442Acute embolism and thrombosis of left tibial vein
I82.443Acute embolism and thrombosis of tibial vein, bilateral
I82.449Acute embolism and thrombosis of unspecified tibial vein

Includes

Official

ICD-10-CM does not list Includes notes for I82.441 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I82.441 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I82.441 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I82.441 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I82.441 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 acute onset with date of symptom onset or diagnosis establishing the acute nature

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 acute onset with date of symptom onset or diagnosis establishing the acute nature

Audit Caution

HCC Buddy guidance
Confusing acute and chronic thrombosis status; acute indicates new onset within the current care episode, while chronic indicates a persistent or recurrent clot documented over time
Assigning the right-sided code when the documentation actually indicates left-sided or bilateral involvement; always verify laterality against imaging and clinical notes
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
I82.431-I82.439 — Popliteal vein thrombosis; popliteal vein is behind the knee, proximal to tibial veins
I82.451-I82.459 — Peroneal vein thrombosis; peroneal veins run alongside tibial veins but are separate vessels
I82.461-I82.469 — Calf muscular vein thrombosis; intramuscular veins are distinct from the main tibial vessels
I80.25x — Phlebitis of calf muscular vein; use for thrombophlebitis with inflammatory component

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 I82.441 an HCC code?

Yes. I82.441 (Acute embolism and thrombosis of right tibial vein) 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: I82.441 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
I82.441
Description
Acute embolism and thrombosis of right tibial vein
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 I82.441 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I82.441

For I82.441 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 I82.441 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I82.441 is the ICD-10-CM diagnosis code for acute embolism and thrombosis of right tibial vein. A blood clot that suddenly forms in the right tibial vein (the larger vein in the lower leg below the knee), blocking blood flow. I82.441 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, I82.441 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, I82.441 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 laterality is documented as 'right' in the medical record before assigning this code. Because I82.441 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 I82.441 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Verify laterality is documented as 'right' in the medical record before assigning this code
  • Distinguish between acute presentation (this code) and chronic/recurrent thrombosis which use different code families

Clinical Significance

Acute tibial vein thrombosis is a distal deep vein thrombosis in the lower leg that, while generally carrying lower pulmonary embolism risk than proximal clots, still requires treatment to prevent proximal extension. Clinical management depends on patient risk factors and whether the thrombosis is symptomatic, typically involving anticoagulation for at least three months. Accurate capture reflects the vascular disease burden and treatment requirements of these patients.

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
  • Laterality (right or left) clearly specified in provider documentation
  • Assessment of risk factors (immobility, recent surgery, malignancy, hypercoagulable state, oral contraceptive use)

Commonly Confused Codes

  • I82.431-I82.439: Popliteal vein thrombosis; popliteal vein is behind the knee, proximal to tibial veins
  • I82.451-I82.459: Peroneal vein thrombosis; peroneal veins run alongside tibial veins but are separate vessels
  • I82.461-I82.469: Calf muscular vein thrombosis; intramuscular veins are distinct from the main tibial vessels
  • I80.25x: Phlebitis of calf muscular vein; use for thrombophlebitis with inflammatory component
  • I82.541-I82.549: Chronic tibial vein thrombosis; verify acute vs. chronic presentation

Child Codes

Code Hierarchy

Because I82.441 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.

I82.441 maps to CMS-HCC V28 category 267, Deep Vein Thrombosis and Pulmonary Embolism. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because I82.441 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work I82.441 in HCC Buddy

Open I82.441 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.