What is ICD-10 code I87.333?

I87.333 is the ICD-10-CM diagnosis code for Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity. A chronic condition where high pressure in the veins of both legs causes skin ulcers along with swelling and redness due to poor circulation. I87.333 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I87.333 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I87.333 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I87.333 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for I87.333?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For I87.333, V28 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle at RAF 0.646 while V24 mapped to Vascular Disease with Complications at RAF 0.383. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting I87.333?

Verify bilateral involvement is explicitly documented for both the ulcer and inflammation components This is the most specific code for this condition when both complications affect both legs Because I87.333 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.

2026 ICD-10-CM I87.333: Chronic venous

ICD-10-CM Code View

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Code lookupI87.333Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

I87.333

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

Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity

A chronic condition where high pressure in the veins of both legs causes skin ulcers along with swelling and redness due to poor circulation.

Buddy Insight

Chronic venous hypertension (idiopathic) with both ulcer and inflammation of the bilateral lower extremity represents the most severe presentation of idiopathic chronic venous disease.

CMS-HCC V28

Mapped

HCC 383

Chronic Ulcer of Skin, Except...

RAF 0.646

CMS-HCC V24

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.383

ACA/HHS

Mapped

HCC 217

HHS-HCC 217

Varies by metal level

ESRD/PACE

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.144

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I87.3Chronic venous hypertension (idiopathic)

I87.33Chronic venous hypertension (idiopathic) with ulcer and inflammation

I87.333Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I87.333 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I87.333 in this effective period.

Related Child Codes

Official

I87.331Chronic venous hypertension (idiopathic) with ulcer and inflammation of right lower extremity

I87.332Chronic venous hypertension (idiopathic) with ulcer and inflammation of left lower extremity

I87.339Chronic venous hypertension (idiopathic) with ulcer and inflammation of unspecified lower extremity

Includes

Official

ICD-10-CM does not list Includes notes for I87.333 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I87.333 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I87.333 in this effective period.

Use Additional

Official

code to specify site and severity of ulcer (L97.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for I87.333 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Diagnosis of chronic venous hypertension explicitly documented

Idiopathic etiology (no identifiable secondary cause) specified or implied

Laterality clearly documented (bilateral lower extremity)

Ulcer characteristics documented (size, depth, location, drainage, wound bed description)

MEAT Support

HCC Buddy guidance

Diagnosis of chronic venous hypertension explicitly documented

Idiopathic etiology (no identifiable secondary cause) specified or implied

Laterality clearly documented (bilateral lower extremity)

Ulcer characteristics documented (size, depth, location, drainage, wound bed description)

Audit Caution

HCC Buddy guidance

Coding ulcer only (I87.31x) when both ulcer and inflammation are documented — always assign the combination code when both are present

Using idiopathic codes when the venous hypertension has a documented secondary cause such as prior deep vein thrombosis

Defaulting to unspecified laterality when the medical record clearly states which leg is affected

Confusing inflammatory changes of venous stasis with separate cellulitis — if true cellulitis is present, it may require an additional code

Common Mistakes

HCC Buddy guidance

I87.331/I87.332 — Unilateral codes; use bilateral only when both legs have ulcer and inflammation

I87.31x — Chronic venous hypertension with ulcer only, without inflammation; if inflammation is not documented, use this category

I87.03x — Postthrombotic syndrome with ulcer and inflammation; use when the etiology is prior deep vein thrombosis rather than idiopathic

I83.2xx — Varicose veins with ulcer and inflammation; different underlying pathology

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 I87.333 an HCC code?

Yes. I87.333 (Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity) maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle under the CMS-HCC V28 risk adjustment model (and Vascular Disease with Complications under V24), with a community non-dual aged RAF of 0.646. It is billable for payment year 2026.

Coder answer: I87.333 is billable and maps to V28 HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: I87.333
Description: Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity
HCC (V28): HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
RAF: 0.646
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

0.646

V24HCC 107, Vascular Disease with Complications

0.383

ESRDHCC 107, Vascular Disease with Complications

0.144

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 I87.333 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I87.333

For I87.333 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 I87.333 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I87.333 is the ICD-10-CM diagnosis code for chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity. A chronic condition where high pressure in the veins of both legs causes skin ulcers along with swelling and redness due to poor circulation. I87.333 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, I87.333 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle (HCC 383) with a community, non-dual, aged base RAF weight of 0.646. Under the older CMS-HCC V24 model, I87.333 maps to Vascular Disease with Complications (HCC 107) with a community, non-dual, aged base RAF weight of 0.383. 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 bilateral involvement is explicitly documented for both the ulcer and inflammation components. Because I87.333 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 I87.333 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify bilateral involvement is explicitly documented for both the ulcer and inflammation components
•This is the most specific code for this condition when both complications affect both legs

Clinical Significance

Chronic venous hypertension (idiopathic) with both ulcer and inflammation of the bilateral lower extremity represents the most severe presentation of idiopathic chronic venous disease. The combination of chronic ulceration and active inflammation indicates advanced tissue breakdown with ongoing inflammatory processes that significantly increase infection risk and delay healing. This condition requires aggressive wound care, anti-inflammatory measures, compression therapy, and often multidisciplinary vascular and wound care team involvement.

Documentation Requirements

✓Diagnosis of chronic venous hypertension explicitly documented
✓Idiopathic etiology (no identifiable secondary cause) specified or implied
✓Laterality clearly documented (bilateral lower extremity)
✓Ulcer characteristics documented (size, depth, location, drainage, wound bed description)
✓Inflammation explicitly documented (erythema, warmth, tenderness, swelling)
✓Both ulcer AND inflammation must be present simultaneously
✓Current comprehensive treatment plan for wound management and inflammation control
✓Assessment of chronic venous insufficiency severity

Commonly Confused Codes

•I87.331/I87.332: Unilateral codes; use bilateral only when both legs have ulcer and inflammation
•I87.31x: Chronic venous hypertension with ulcer only, without inflammation; if inflammation is not documented, use this category
•I87.03x: Postthrombotic syndrome with ulcer and inflammation; use when the etiology is prior deep vein thrombosis rather than idiopathic
•I83.2xx: Varicose veins with ulcer and inflammation; different underlying pathology
•L97.xxx: Non-pressure chronic ulcer of lower limb; should not be used when the ulcer is due to venous hypertension