I82.569
BillableChronic embolism and thrombosis of unspecified calf muscular vein
HCC Category Mapping
V28HCC 267 — Vascular Disease
0.356V24HCC 108 — Vascular Disease
0.297ESRDHCC 108 — Vascular Disease
0.000RxHCCHCC 215 — Pulmonary Embolism and Other Vascular Disease
0.000What This Code Means
A chronic blood clot in a calf muscular vein when the specific side (right or left) is not documented or specified.
Coding Tips
- •This is a less specific code; query provider if laterality can be determined from clinical documentation
- •Use only when laterality is truly unspecified or unknown
Clinical Significance
Chronic calf muscular vein thrombosis (involving the soleal or gastrocnemius veins) represents an organized thrombus in the muscular venous system of the calf. While historically considered less clinically significant than proximal deep vein thrombosis, calf muscular vein thrombosis can propagate proximally and cause post-thrombotic syndrome. This diagnosis is important for risk adjustment as it reflects chronic vascular disease requiring ongoing management.
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., calf muscular)
- ✓Query provider for laterality (right, left, or bilateral) when not documented
- ✓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
I82.469 — Acute embolism and thrombosis of calf muscular vein; verify documentation states chronic, not acuteI82.55- — Chronic embolism and thrombosis of peroneal vein; the peroneal vein is an axial vein, distinct from the muscular veins of the calfI82.54- — Chronic embolism and thrombosis of tibial vein; tibial veins are axial deep veins, not muscular veinsI87.01- — Postthrombotic syndrome; may develop following calf muscular vein thrombosis and should be coded as an additional diagnosis
Code Hierarchy
└I82Other venous embolism and thrombosis└I82.5Chronic embolism and thrombosis of deep veins of lower extremity└I82.56Chronic embolism and thrombosis of calf muscular vein└I82.569Chronic embolism and thrombosis of unspecified calf muscular vein
└I82.569Chronic embolism and thrombosis of unspecified calf muscular vein