# Deep Venous Thrombosis (DVT) Coding Help



## HCCCoder (Nov 11, 2013)

Can anyone provide a good backup document from CMS or a reliable source on DVT coding? Documentation states "DVT- on chronic anticoagulant therapy." Some coders say it needs to be coded as Chronic DVT (453.5x) because if the pt has acute DVT, she/he should be in the hospital and since the pt is on chronic anticoagulant, it should be coded as chronic. 

And some coders say, according to the ICD-9 book, it says "Assign as default code for deep venous thrombosis" (453.4x). We can not assume the DVT is chronic, unless it is being specified by the physician. And in this case the word "chronic" pertains to the antigoagulation therapy not DVT.

Any help will be appreciated.

P.S. According to Coding Clinic, these cases should be quieried. But right now we don't have that luxury, we just need to know what is the best code selection and WHY. 

So the QUESTION is- Besides the ICD-9 index mapping, why do we code "DVT" as 453.40 (acute) when pt is on chronic anticoagulant therapy for years? 

Thank you.


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## tharal (Nov 12, 2013)

If the documentation is only DVT on chronic anticoagulation therapy we need to use 453.40 DVT NOS. if its documented as acute code will go to 453.5x and for acute also its 453.4x. For acute DVT also physician will prescribe anticoagulants.

Thara L CPC H


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## KaylaR2007 (Jan 11, 2014)

I use 453.5x.  The 2014 Coder's Desk Reference page 434 provides further insight.  Hope this helps.


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