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I87.011 ICD-10-CM Code: Postthrombotic syndrome with ulcer of right lower extremity

Compare with another code for I87.011Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 Excludes1 · 1 use-additional code
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 107

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Use additional codefrom I87.01Report with this code when documented
  • Use additional code to specify site and severity of ulcer (L97.-)
Excludes1from I87.0Not reported with this code unless documented as unrelated
  • chronic venous hypertension without deep vein thrombosis (I87.3-)

Where it sits Source: CMS/NCHS

Under:Chapter 9: Diseases of the Circulatory SystemI80-I89 Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classifiedI87 Other disorders of veinsI87.0 Postthrombotic syndromeI87.01 Postthrombotic syndrome with ulcer

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 299 — PERIPHERAL VASCULAR DISORDERS WITH MCC (MDC 05)
  • MS-DRG 300 — PERIPHERAL VASCULAR DISORDERS WITH CC (MDC 05)
  • MS-DRG 301 — PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC (MDC 05)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

Other models: CMS-HCC V22 HCC 107

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I87.011 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on I87.011 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from I87.0

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to specify site and severity of ulcer (L97.-)

Source: inherited from I87.01

Coder workflow for I87.011

MedCoder structured workflow — derived from this code’s own official record

Before you code I87.011

  1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    ReviewI87.012 · left, I87.013 · bilateral, I87.019 · unspecified

    Guide: Laterality coding →

  2. I87.011’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with I87.011. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in I87.011’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewI87.3

  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

    ReviewI87.012 · left, I87.013 · bilateral, I87.019 · unspecified

Consider I87.011. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting I87.011(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with I87.011: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareI87.3

    See the official tabular notes · Guidelines I.A.12.a

  • Use Additional Code — after identifying I87.011(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I87.011 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewL97

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition I87.011 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewI87.3

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

ReviewI87.012 · left, I87.013 · bilateral, I87.019 · unspecified

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is I87.011 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse I87.011 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of I87.011 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • I87.3— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of chronic venous hypertension without deep vein thrombosis moves the case to I87.3; the two are not reported together unless documented as unrelated.

    Full comparison: I87.011 vs I87.3 →

  • I87.019— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Postthrombotic syndrome with ulcer of unspecified lower extremity” takes I87.019; specificity in the record moves it back here.

    Full comparison: I87.011 vs I87.019 →

  • I87.012— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition with a different side named (the opposite side, both sides, or none); the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to I87.012.

    Full comparison: I87.011 vs I87.012 →

  • I87.013— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition with a different side named (the opposite side, both sides, or none); the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: Documentation of both sides moves the case to I87.013.

    Full comparison: I87.011 vs I87.013 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Postthrombotic syndrome with ulcer of right lower extremity is a billable ICD-10-CM diagnosis code (I87.011).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  2. 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name I87.011 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: I87.3 — Chronic venous hypertension (idiopathic) (via I87.0.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code First instruction: L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified (via I87.01.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 40 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 299 (MDC 05), DRG 300 (MDC 05), DRG 301 (MDC 05).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):CIR036 — Postthrombotic syndrome and venous insufficiency/hypertension (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

I80.229 — Phlebitis and thrombophlebitis of unspecified popliteal vein, I80.231 — Phlebitis and thrombophlebitis of right tibial vein, I80.232 — Phlebitis and thrombophlebitis of left tibial vein, I80.233 — Phlebitis and thrombophlebitis of tibial vein, bilateral, I80.239 — Phlebitis and thrombophlebitis of unspecified tibial vein, I80.241 — Phlebitis and thrombophlebitis of right peroneal vein, I80.242 — Phlebitis and thrombophlebitis of left peroneal vein, I80.243 — Phlebitis and thrombophlebitis of peroneal vein, bilateral, I80.249 — Phlebitis and thrombophlebitis of unspecified peroneal vein, I80.251 — Phlebitis and thrombophlebitis of right calf muscular vein, I80.252 — Phlebitis and thrombophlebitis of left calf muscular vein, I80.253 — Phlebitis and thrombophlebitis of calf muscular vein, bilateral, I80.259 — Phlebitis and thrombophlebitis of unspecified calf muscular vein, I80.291 — Phlebitis and thrombophlebitis of other deep vessels of right lower extremity, I80.292 — Phlebitis and thrombophlebitis of other deep vessels of left lower extremity, I80.293 — Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral, I80.299 — Phlebitis and thrombophlebitis of other deep vessels of unspecified lower extremity, I80.3 — Phlebitis and thrombophlebitis of lower extremities, unspecified, I80.8 — Phlebitis and thrombophlebitis of other sites, I80.9 — Phlebitis and thrombophlebitis of unspecified site, +19 more

Same condition, different side

Same title, differing only in which side of the body it names: right, left, bilateral or unspecified.

I87.012 — Postthrombotic syndrome with ulcer of left lower extremity (left)Compare I87.011 vs I87.012 →, I87.013 — Postthrombotic syndrome with ulcer of bilateral lower extremity (bilateral)Compare I87.011 vs I87.013 →, I87.019 — Postthrombotic syndrome with ulcer of unspecified lower extremity (unspecified)Compare I87.011 vs I87.019 →

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle) for risk-adjusted payment.

I83.215 — Varicose veins of right lower extremity with both ulcer other part of foot and inflammation, I83.218 — Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation, I83.219 — Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation, I83.221 — Varicose veins of left lower extremity with both ulcer of thigh and inflammation, I83.222 — Varicose veins of left lower extremity with both ulcer of calf and inflammation, I83.223 — Varicose veins of left lower extremity with both ulcer of ankle and inflammation, I83.224 — Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation, I83.225 — Varicose veins of left lower extremity with both ulcer other part of foot and inflammation, I83.228 — Varicose veins of left lower extremity with both ulcer of other part of lower extremity and inflammation, I83.229 — Varicose veins of left lower extremity with both ulcer of unspecified site and inflammation, I87.012 — Postthrombotic syndrome with ulcer of left lower extremity, I87.013 — Postthrombotic syndrome with ulcer of bilateral lower extremity, I87.019 — Postthrombotic syndrome with ulcer of unspecified lower extremity, I87.031 — Postthrombotic syndrome with ulcer and inflammation of right lower extremity, I87.032 — Postthrombotic syndrome with ulcer and inflammation of left lower extremity, I87.033 — Postthrombotic syndrome with ulcer and inflammation of bilateral lower extremity, I87.039 — Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity, I87.311 — Chronic venous hypertension (idiopathic) with ulcer of right lower extremity, I87.312 — Chronic venous hypertension (idiopathic) with ulcer of left lower extremity, I87.313 — Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity, +287 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene, Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone, Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle, Pressure Ulcer of Skin with Full Thickness Skin Loss, Pressure Ulcer of Skin with Partial Thickness Skin Loss

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Postthrombotic syndrome and venous insufficiency/hypertension).

I86.8 — Varicose veins of other specified sites, I87.001 — Postthrombotic syndrome without complications of right lower extremity, I87.002 — Postthrombotic syndrome without complications of left lower extremity, I87.003 — Postthrombotic syndrome without complications of bilateral lower extremity, I87.009 — Postthrombotic syndrome without complications of unspecified extremity, I87.012 — Postthrombotic syndrome with ulcer of left lower extremity, I87.013 — Postthrombotic syndrome with ulcer of bilateral lower extremity, I87.019 — Postthrombotic syndrome with ulcer of unspecified lower extremity, I87.021 — Postthrombotic syndrome with inflammation of right lower extremity, I87.022 — Postthrombotic syndrome with inflammation of left lower extremity, I87.023 — Postthrombotic syndrome with inflammation of bilateral lower extremity, I87.029 — Postthrombotic syndrome with inflammation of unspecified lower extremity, I87.031 — Postthrombotic syndrome with ulcer and inflammation of right lower extremity, I87.032 — Postthrombotic syndrome with ulcer and inflammation of left lower extremity, I87.033 — Postthrombotic syndrome with ulcer and inflammation of bilateral lower extremity, I87.039 — Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity, I87.091 — Postthrombotic syndrome with other complications of right lower extremity, I87.092 — Postthrombotic syndrome with other complications of left lower extremity, I87.093 — Postthrombotic syndrome with other complications of bilateral lower extremity, I87.099 — Postthrombotic syndrome with other complications of unspecified lower extremity, +22 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of I87.011 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I87.011 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 15,708 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I87.011 — Postthrombotic syndrome with ulcer of right lower extremity." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i87.011-postthrombotic-syndrome-with-ulcer-of-right-lower-extremity

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Postthrombotic syndrome with ulcer of right lower extremity

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I87.011 in its code family, with their registry titles.

View all codes in the I87 family