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I82.451 ICD-10-CM Code: Acute embolism and thrombosis of right peroneal vein

I82.451 maps to CMS-HCC V28 267 (RAF 0.294). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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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)

I82.451

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

Acute embolism and thrombosis of right peroneal vein

A blood clot that suddenly forms in the peroneal vein (a deep vein in the right calf/lower leg), blocking blood flow. This is a serious condition that requires immediate medical attention to prevent the clot from traveling to the lungs.

Buddy the Bee presenting code insight

Buddy Insight

Acute peroneal vein thrombosis is a distal deep vein thrombosis of the lower leg that requires clinical assessment for proximal extension risk and typically warrants anticoagulation therapy.

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
I82.45Acute embolism and thrombosis of peroneal vein
I82.451Acute embolism and thrombosis of right peroneal vein

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I82.451 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I82.451 in this effective period.

Related Child Codes

Official
I82.452Acute embolism and thrombosis of left peroneal vein
I82.453Acute embolism and thrombosis of peroneal vein, bilateral
I82.459Acute embolism and thrombosis of unspecified peroneal vein

Includes

Official

ICD-10-CM does not list Includes notes for I82.451 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I82.451 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I82.451 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I82.451 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I82.451 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
I82.441-I82.449 — Tibial vein thrombosis; tibial and peroneal veins run parallel but are separate vessels
I82.461-I82.469 — Calf muscular vein thrombosis; intramuscular veins (soleal/gastrocnemius) differ from peroneal veins
I82.431-I82.439 — Popliteal vein thrombosis; popliteal vein is proximal to peroneal veins
I80.25x — Phlebitis of calf muscular vein; different vessel type and includes 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 I82.451 an HCC code?

Yes. I82.451 (Acute embolism and thrombosis of right peroneal 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: I82.451 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
I82.451
Description
Acute embolism and thrombosis of right peroneal 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 I82.451 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I82.451

For I82.451 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 I82.451 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I82.451 is the ICD-10-CM diagnosis code for acute embolism and thrombosis of right peroneal vein. A blood clot that suddenly forms in the peroneal vein (a deep vein in the right calf/lower leg), blocking blood flow. This is a serious condition that requires immediate medical attention to prevent the clot from traveling to the lungs. I82.451 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, I82.451 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, I82.451 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; if bilateral or left-sided, use different codes (I82.452 for left, I82.453 for bilateral). Because I82.451 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 I82.451 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; if bilateral or left-sided, use different codes (I82.452 for left, I82.453 for bilateral)
  • Confirm the clot is acute (sudden onset) rather than chronic; acute thrombosis typically occurs within days, while chronic codes (I82.55x) apply to long-standing clots

Clinical Significance

Acute peroneal vein thrombosis is a distal deep vein thrombosis of the lower leg that requires clinical assessment for proximal extension risk and typically warrants anticoagulation therapy. While peroneal vein clots are considered distal and may carry lower embolization risk, they can propagate proximally if untreated. Accurate coding ensures appropriate risk stratification and reflects the need for vascular disease monitoring.

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

  • I82.441-I82.449: Tibial vein thrombosis; tibial and peroneal veins run parallel but are separate vessels
  • I82.461-I82.469: Calf muscular vein thrombosis; intramuscular veins (soleal/gastrocnemius) differ from peroneal veins
  • I82.431-I82.439: Popliteal vein thrombosis; popliteal vein is proximal to peroneal veins
  • I80.25x: Phlebitis of calf muscular vein; different vessel type and includes inflammatory component
  • I82.551-I82.559: Chronic peroneal vein thrombosis; verify acute vs. chronic presentation

Child Codes

Code Hierarchy

I82.451 code history

Code setChange
FY2020 (effective Oct 1, 2019)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Because I82.451 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.

I82.451 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 I82.451 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.

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Open I82.451 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.