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2025 ICD-10-CM code I82.4Y

Acute embolism and thrombosis of unspecified deep veins of the proximal lower extremity.

Use the most specific code possible. If the location of the DVT is known, use the more specific code (I82.4Y1, I82.4Y2, etc.).Code for any associated complications (e.g., pulmonary embolism).

Modifiers may be applicable depending on the circumstances of service delivery (e.g., bilateral involvement).

Medical necessity is established by the presence of clinical findings consistent with acute DVT, confirmed by appropriate diagnostic imaging. Treatment is necessary to prevent potentially life-threatening complications such as pulmonary embolism.

Diagnosis and management of the acute embolism and thrombosis. This includes ordering investigations (e.g., Doppler ultrasound), initiating anticoagulation therapy (e.g., heparin, warfarin), patient education, monitoring for complications (e.g., pulmonary embolism), and follow-up care.

IMPORTANT:I82.4Y1 (right proximal lower extremity), I82.4Y2 (left proximal lower extremity), I82.4Y3 (bilateral), I82.4Y9 (unspecified side).

In simple words: This code means a blood clot has formed in a deep vein in the upper part of your leg (thigh area).The exact location of the clot isn't specified.

This ICD-10-CM code signifies acute embolism and thrombosis affecting unspecified deep veins located in the proximal (upper) portion of the lower extremity.The specific vein involved is not specified. This diagnosis requires confirmation through appropriate clinical investigations, such as Doppler ultrasound or venography, to establish the presence of both embolism (obstruction by a blood clot) and thrombosis (blood clot formation within a vessel).

Example 1: A 60-year-old male presents with swelling, pain, and redness in his right thigh following a long flight.Doppler ultrasound confirms acute deep vein thrombosis (DVT) in the right proximal thigh. The code I82.4Y2 would be used. , A 35-year-old female with a history of Factor V Leiden presents with leg swelling. Venography demonstrates an acute DVT in her left proximal thigh. The code I82.4Y1 would be used. , A 72-year-old post-surgical patient develops bilateral leg swelling and pain.Investigations show bilateral acute DVT in the proximal thighs.I82.4Y3 would be applicable.

Detailed history and physical examination documenting symptoms (pain, swelling, redness, warmth). Results of diagnostic imaging studies (Doppler ultrasound, venography) confirming the presence of DVT.Specify affected extremity (right, left, bilateral) to the extent possible.

** This code should only be used when the location of the DVT is limited to the proximal lower extremity, and the specific vein is not identifiable.Always ensure thorough clinical documentation supports the use of this code.

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