I80.249 — Phlebitis and thrombophlebitis of unspecified peroneal vein
Is I80.249 billable?
Yes, but I80.249 will trip a Medicare edit. I80.249 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists I80.249 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
I80.249 at a glance
| Code | I80.249 |
|---|---|
| Description | Phlebitis and thrombophlebitis of unspecified peroneal vein |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to I80.249?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name I80.249 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does I80.249 group to?
I80.249 sits in MDC 05 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 299Peripheral Vascular Disorders with MCCmedical
- 300Peripheral Vascular Disorders with CCmedical
- 301Peripheral Vascular Disorders without CC/MCCmedical
As a secondary diagnosis, I80.249 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I80.249 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under I80.24, the nearest indexed parent of I80.249. Use them to find the family, then select the specific code.
- Phlebitis › peroneal vein (infective) (pyemic) (septic) (suppurative)
- Thrombophlebitis › peroneal vein
Excludes1 — never code together — inherited from I80
The conditions below can never be reported together with I80.249 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first — inherited from I80
The underlying condition below must be sequenced before I80.249. I80.249 describes a manifestation and cannot be the principal or first-listed diagnosis.
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I80.249, but a patient may have both at the same time. When documentation supports it, I80.249 and the excluded code may both 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.-)
How long has I80.249 existed?
I80.249 first appears in FY2021 (FY2020 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.