ICD-10-CM Billable Code

I87.031

Postthrombotic syndrome with ulcer and inflammation of right lower extremity

Clinical Classification Guidelines

Medical Intelligence & Overview

Postthrombotic syndrome (PTS) is a long-term complication that can develop after a deep vein thrombosis (DVT), often affecting the legs. When it involves ulceration and inflammation, it can cause significant discomfort and skin changes, especially in the right lower extremity. This condition is characterized by persistent symptoms such as swelling, skin discoloration, pain, and in more severe cases, ulcers that may become infected.

Causes & Symptoms

Clinical Causes: Previous deep vein thrombosis (DVT) in the right leg Venous hypertension caused by damaged valves in the veins Chronic inflammation of the affected veins Inadequate blood flow returning from the leg Obstruction or narrowing of the veins due to scarring or thrombosis

Key Symptoms: Swelling in the right lower leg Skin discoloration, often brownish or reddish Heaviness or aching sensation in the leg Persistent skin inflammation Ulcer formation, particularly on the inner ankle or lower leg Pain and tenderness in the affected area Warmth or redness indicating possible infection Skin ulcer that may be slow to heal

Diagnostic & Treatment

Diagnosis Path: Diagnosis of postthrombotic syndrome involves a combination of medical history review, physical examination, and diagnostic tests. Healthcare providers may recommend:

Treatment Protocols: While treatment strategies aim to manage symptoms and prevent complications, they may include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is I87.031 a billable ICD-10 code?
Yes, I87.031 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report I87.031?
Clinical documentation must specify the nature of Postthrombotic syndrome with ulcer and inflammation of right lower extremity and any associated comorbidities for accurate reporting.

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