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I82.513 ICD-10-CM Code: Chronic embolism and thrombosis of femoral vein, bilateral

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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)

I82.513

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

Chronic embolism and thrombosis of femoral vein, bilateral

Long-standing blood clots in the femoral veins of both legs.

Buddy the Bee presenting code insight

Buddy Insight

Chronic femoral vein thrombosis is a major proximal deep vein thrombosis that indicates a long-standing clot in one of the principal deep veins of the thigh.

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
I82.5Chronic embolism and thrombosis of deep veins of lower extremity
I82.51Chronic embolism and thrombosis of femoral vein
I82.513Chronic embolism and thrombosis of femoral vein, bilateral

Inclusion Terms

Official
  • Chronic embolism and thrombosis of common femoral vein
  • Chronic embolism and thrombosis of deep femoral vein

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I82.513 in this effective period.

Related Child Codes

Official
I82.511Chronic embolism and thrombosis of right femoral vein
I82.512Chronic embolism and thrombosis of left femoral vein
I82.519Chronic embolism and thrombosis of unspecified femoral vein

Includes

Official

ICD-10-CM does not list Includes notes for I82.513 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I82.513 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I82.513 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I82.513 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I82.513 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation explicitly stating 'chronic' deep vein thrombosis (not assumed from duration of treatment)
Clinical evidence supporting the diagnosis such as duplex ultrasound, venography, or other imaging results
Specific vein location documented (e.g., femoral)
Documentation confirming bilateral involvement (both extremities affected)

MEAT Support

HCC Buddy guidance
Provider documentation explicitly stating 'chronic' deep vein thrombosis (not assumed from duration of treatment)
Clinical evidence supporting the diagnosis such as duplex ultrasound, venography, or other imaging results
Specific vein location documented (e.g., femoral)
Documentation confirming bilateral involvement (both extremities affected)

Audit Caution

HCC Buddy guidance
Confusing acute and chronic deep vein thrombosis — these have different code families (I82.4- for acute lower extremity, I82.5- for chronic lower extremity) and the provider must explicitly document 'chronic'
Assigning bilateral code when only one side is confirmed; documentation must clearly state involvement of both extremities
Coding to an unspecified deep vein when the femoral vein is clearly documented — always review imaging and clinical notes for the specific vein involved
Assuming deep vein thrombosis is chronic solely because the patient has been on anticoagulation for a long time; the provider must explicitly document the condition as chronic

Common Mistakes

HCC Buddy guidance
I82.413 — Acute embolism and thrombosis of femoral vein; ensure documentation explicitly states chronic status
I82.50- — Chronic embolism and thrombosis of unspecified deep veins; use the femoral-specific code when the femoral vein is documented
I82.52- — Chronic embolism and thrombosis of iliac vein; the iliac vein is more proximal than the femoral; verify exact vein documented
I87.01- — Postthrombotic syndrome; code separately if post-thrombotic sequelae are present alongside chronic deep vein thrombosis

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 I82.513 an HCC code?

Yes. I82.513 (Chronic embolism and thrombosis of femoral vein, 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: I82.513 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
I82.513
Description
Chronic embolism and thrombosis of femoral vein, bilateral
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 I82.513 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I82.513

For I82.513 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 I82.513 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I82.513 is the ICD-10-CM diagnosis code for chronic embolism and thrombosis of femoral vein, bilateral. Long-standing blood clots in the femoral veins of both legs. I82.513 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, I82.513 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, I82.513 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.

This code indicates bilateral femoral vein involvement; confirm documentation states both legs are affected. Because I82.513 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 I82.513 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code indicates bilateral femoral vein involvement; confirm documentation states both legs are affected
  • Do not use if only one femoral vein is affected; use I82.511 or I82.512 instead

Clinical Significance

Chronic femoral vein thrombosis is a major proximal deep vein thrombosis that indicates a long-standing clot in one of the principal deep veins of the thigh. This condition significantly increases the risk of post-thrombotic syndrome with chronic leg swelling, pain, and skin changes, and requires ongoing anticoagulation therapy. Femoral vein involvement is a key indicator of substantial vascular disease burden for risk adjustment purposes.

Documentation Requirements

  • Provider documentation explicitly stating 'chronic' deep vein thrombosis (not assumed from duration of treatment)
  • Clinical evidence supporting the diagnosis such as duplex ultrasound, venography, or other imaging results
  • Specific vein location documented (e.g., femoral)
  • Documentation confirming bilateral involvement (both extremities affected)
  • Current treatment plan including anticoagulation therapy and duration
  • Assessment and monitoring notes demonstrating the condition is being actively managed
  • Documentation of chronicity such as 'chronic,' 'old,' 'long-standing,' or history of prior acute deep vein thrombosis that has transitioned to chronic status

Commonly Confused Codes

  • I82.413: Acute embolism and thrombosis of femoral vein; ensure documentation explicitly states chronic status
  • I82.50-: Chronic embolism and thrombosis of unspecified deep veins; use the femoral-specific code when the femoral vein is documented
  • I82.52-: Chronic embolism and thrombosis of iliac vein; the iliac vein is more proximal than the femoral; verify exact vein documented
  • I87.01-: Postthrombotic syndrome; code separately if post-thrombotic sequelae are present alongside chronic deep vein thrombosis

Child Codes

Code Hierarchy

Because I82.513 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.

I82.513 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 I82.513 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 I82.513 in HCC Buddy

Open I82.513 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.