I82.531 ICD-10-CM Code: Chronic embolism and thrombosis of right popliteal vein

Code

I82.531

Description

Chronic embolism and thrombosis of right popliteal vein

HCC (V28)

HCC 267 — Deep Vein Thrombosis and Pulmonary Embolism

RAF reference coefficient

0.294

Billable

Yes

Payment year

2026

HCC Category Mapping

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work I82.531 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for I82.531

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I82.531 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Verify the laterality (right vs. left) is clearly documented in the medical record before assigning this code
• •Confirm the thrombosis is documented as chronic rather than acute, as acute popliteal vein thrombosis uses different ICD-10 codes (I82.51-)

Clinical Significance

Chronic popliteal vein thrombosis involves a persistent clot in the major vein behind the knee, which serves as the transition point between proximal and distal deep venous systems. This location is clinically significant because popliteal vein thrombosis carries meaningful risk of post-thrombotic syndrome and may impair venous return from the entire lower leg. Accurate documentation of chronic popliteal vein thrombosis is important for capturing vascular disease complexity in risk adjustment.

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., popliteal)
• ✓Documentation confirming right-sided laterality
• ✓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

• •I82.431: Acute embolism and thrombosis of popliteal vein; verify documentation states chronic, not acute
• •I82.54-: Chronic embolism and thrombosis of tibial vein; the tibial vein is more distal than the popliteal; confirm exact location
• •I82.51-: Chronic embolism and thrombosis of femoral vein; the femoral vein is more proximal than the popliteal; confirm anatomical site
• •I87.01-: Postthrombotic syndrome; may develop as a complication of chronic popliteal vein thrombosis and should be coded separately

Child Codes