2027 ICD-10-CM Diagnosis Code I80.252Phlebitis and thrombophlebitis of left calf muscular vein
I80.252 is a billable ICD-10-CM diagnosis code for phlebitis and thrombophlebitis of left calf muscular vein. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 299 through 301, 791, 793. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acute phlebitis; thrombophlebitis and thromboembolism.
For Medicare Advantage risk adjustment, I80.252 maps to CMS-HCC Category 267 (Deep Vein Thrombosis and Pulmonary Embolism) under the V28 model, adding a risk factor of about 0.294 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
I80.252 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to I80.252: its own notes plus those printed at I80 and Chapter 9. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- endophlebitis
- inflammation, vein
- periphlebitis
- suppurative phlebitis
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
Code First
The underlying condition named in the note is sequenced before this code.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Deep Vein Thrombosis
Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or thigh. If the vein swells, the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem in the lung, called a pulmonary embolism.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement I80.252 replaces the following previously assigned code(s):
- I80.292 - Phlebitis and thombophlb of deep vessels of l low extrem
Questions About I80.252Overview
What is the ICD-10 code for phlebitis and thrombophlebitis of left calf muscular vein?
The ICD-10-CM code for phlebitis and thrombophlebitis of left calf muscular vein is I80.252 (sometimes written as I80252). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is I80.252 (Phlebitis and thrombophlebitis of calf muscular vein) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report phlebitis and thrombophlebitis of left calf muscular vein on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does I80.252 group to?
When phlebitis and thrombophlebitis of left calf muscular vein is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 301, 300, 299, with relative weights from 0.7132 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Can I80.252 be reported with a code from I82.4?
Not as a rule. The Excludes1 note at I80, which applies to I80.252, lists "venous embolism and thrombosis of lower extremities (I82.4-, I82.5-, I82.81-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is coded first with I80.252?
The Code First note at I80, which applies to I80.252, reads: if applicable: phlebitis and thrombophlebitis complicating abortion, ectopic or molar pregnancy (O00-O07, O08.7); phlebitis and thrombophlebitis complicating pregnancy, childbirth and the puerperium (O22.-, O87.-). When one of these applies, it is sequenced before I80.252.
What HCC is I80.252?
I80.252 (phlebitis and thrombophlebitis of left calf muscular vein) maps to CMS-HCC Category 267 (Deep Vein Thrombosis and Pulmonary Embolism), commonly written as HCC 267, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 108 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 215.
Does I80.252 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I80.252 adds a risk adjustment factor of about 0.294 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.245 to 0.568 depending on the payment segment). HCC 267 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 267 category page.
