I87.019 — Postthrombotic syndrome with ulcer of unspecified lower extremity
Is I87.019 billable?
Yes, but I87.019 will trip a Medicare edit. I87.019 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists I87.019 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.
I87.019 at a glance
| Code | I87.019 |
|---|---|
| Description | Postthrombotic syndrome with ulcer of unspecified lower extremity |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to I87.019?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name I87.019 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 I87.019 group to?
I87.019 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, I87.019 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I87.019 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under I87.01, the nearest indexed parent of I87.019. Use them to find the family, then select the specific code.
- Syndrome › postthrombotic › with › ulcer
Excludes1 — never code together — inherited from I87.0
The conditions below can never be reported together with I87.019 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- chronic venous hypertension without deep vein thrombosis (I87.3-)
Use additional code — inherited from I87.01
Report an additional code alongside I87.019 to fully describe the condition. I87.019 is sequenced first.
- code to specify site and severity of ulcer (L97.-)
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I87.019, but a patient may have both at the same time. When documentation supports it, I87.019 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 I87.019 existed?
I87.019 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.