ICD-10: I82.413

ICD-10 code I82.413 refers to "Acute embolism and thrombosis of femoral vein, bilateral." This diagnosis is part of a broader classification of venous disorders, specifically focusing on the acute conditions affecting the femoral veins, which are major veins located in the thigh.

Clinical Description

Definition

Acute embolism and thrombosis of the femoral vein occur when a blood clot (thrombus) forms in the femoral vein, obstructing blood flow. If the clot dislodges, it can travel to other parts of the body, potentially leading to serious complications such as pulmonary embolism. The term "bilateral" indicates that the condition affects both the right and left femoral veins simultaneously.

Symptoms

Patients with acute embolism and thrombosis of the femoral vein may present with a variety of symptoms, including:
- Swelling: Noticeable swelling in the affected leg(s) due to fluid accumulation.
- Pain: Localized pain in the thigh or groin area, which may worsen with movement.
- Discoloration: The skin over the affected area may appear red or discolored.
- Warmth: The affected leg may feel warmer than the other leg.
- Difficulty Walking: Patients may experience difficulty or pain when walking.

Risk Factors

Several factors can increase the risk of developing acute embolism and thrombosis in the femoral vein, including:
- Prolonged Immobility: Extended periods of sitting or lying down, such as during long flights or bed rest.
- Surgery: Recent surgical procedures, particularly orthopedic surgeries, can increase the risk.
- Obesity: Excess body weight can contribute to venous stasis.
- Hormonal Factors: Use of hormonal contraceptives or hormone replacement therapy can elevate risk.
- Age: Older adults are generally at higher risk for venous thromboembolism.

Diagnosis and Treatment

Diagnostic Procedures

To confirm a diagnosis of acute embolism and thrombosis of the femoral vein, healthcare providers may utilize:
- Ultrasound: A non-invasive imaging technique that can visualize blood flow and detect clots.
- D-dimer Test: A blood test that measures the presence of a substance released when a blood clot breaks up; elevated levels may indicate thrombosis.
- CT or MRI: In some cases, advanced imaging may be required to assess the extent of the embolism.

Treatment Options

Management of acute embolism and thrombosis typically involves:
- Anticoagulation Therapy: Medications such as heparin or warfarin are commonly prescribed to prevent further clot formation.
- Thrombolysis: In severe cases, thrombolytic agents may be administered to dissolve the clot.
- Compression Therapy: Graduated compression stockings may be recommended to reduce swelling and improve venous return.
- Surgical Intervention: In rare cases, surgical procedures may be necessary to remove the clot.

Conclusion

ICD-10 code I82.413 encapsulates a critical condition that requires prompt diagnosis and treatment to prevent serious complications. Understanding the clinical presentation, risk factors, and management strategies is essential for healthcare providers to effectively address this condition and improve patient outcomes. Regular monitoring and preventive measures are also vital for individuals at risk of venous thromboembolism.

Acute embolism and thrombosis of the femoral vein, classified under ICD-10 code I82.413, is a serious medical condition that requires prompt recognition and management. This condition is characterized by the obstruction of blood flow in the femoral veins due to a thrombus (blood clot) or an embolus (a clot that has traveled from another location). Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and treatment.

Clinical Presentation

Definition and Pathophysiology

Acute embolism and thrombosis of the femoral vein can occur unilaterally or bilaterally, with the bilateral presentation being denoted by the I82.413 code. This condition often arises from deep vein thrombosis (DVT), where a clot forms in the deep veins of the legs, potentially leading to embolization to the pulmonary circulation, resulting in pulmonary embolism (PE) if not treated promptly[3][4].

Risk Factors

Several patient characteristics increase the likelihood of developing acute femoral vein thrombosis, including:
- Prolonged immobility: Situations such as long flights, bed rest, or post-surgical recovery can contribute to venous stasis.
- Obesity: Excess body weight increases pressure in the veins of the legs.
- Age: Older adults are at higher risk due to decreased mobility and other comorbidities.
- Hormonal factors: Use of oral contraceptives or hormone replacement therapy can elevate the risk.
- Medical history: Previous episodes of DVT or PE, cancer, and certain genetic conditions affecting blood clotting can predispose individuals to thrombosis[5][6].

Signs and Symptoms

Common Symptoms

Patients with acute embolism and thrombosis of the femoral vein may present with a variety of symptoms, including:
- Swelling: Often unilateral, but can be bilateral in cases of bilateral thrombosis. The affected leg may appear larger than the other.
- Pain: Patients may experience pain or tenderness in the thigh or calf, which can be exacerbated by movement or palpation.
- Discoloration: The skin over the affected area may appear red or have a bluish tint (cyanosis).
- Warmth: The affected leg may feel warmer to the touch compared to the other leg.
- Pitting edema: Swelling that retains an indentation when pressed[4][7].

Clinical Signs

Healthcare providers may observe specific clinical signs during examination:
- Homan's sign: Pain in the calf upon dorsiflexion of the foot, although this sign is not always reliable.
- Palpable cord: A firm, cord-like structure may be felt along the course of the affected vein.
- Asymmetry: Measurement of the circumference of both legs may reveal significant differences, indicating swelling in the affected leg[6][8].

Diagnostic Evaluation

Imaging Studies

To confirm the diagnosis of acute embolism and thrombosis of the femoral vein, several imaging modalities may be employed:
- Ultrasound: Doppler ultrasound is the first-line imaging technique used to visualize the thrombus and assess blood flow in the veins.
- CT venography: This may be used in complex cases or when there is a suspicion of pelvic vein involvement[4][5].

Laboratory Tests

• D-dimer levels: Elevated levels can indicate the presence of an abnormal clotting process, although they are not specific to DVT[6][9].

Conclusion

Acute embolism and thrombosis of the femoral vein, particularly when bilateral, is a critical condition that necessitates immediate medical attention. Recognizing the clinical presentation, signs, and symptoms, along with understanding patient characteristics and risk factors, is essential for timely diagnosis and intervention. Early detection and treatment can significantly reduce the risk of complications, including pulmonary embolism, which can be life-threatening. If you suspect a patient may have this condition, prompt evaluation and management are crucial.

ICD-10 code I82.413 refers specifically to "Acute embolism and thrombosis of femoral vein, bilateral." This code is part of a broader classification system used for diagnosing and billing purposes in healthcare. Below are alternative names and related terms associated with this condition:

Alternative Names

1. Bilateral Femoral Vein Thrombosis: This term emphasizes the presence of blood clots in both femoral veins.
2. Bilateral Acute Venous Thrombosis: A more general term that can refer to acute thrombosis occurring in any bilateral veins, including the femoral veins.
3. Bilateral Deep Vein Thrombosis (DVT): While DVT typically refers to clots in the deep veins of the legs, this term can be used interchangeably when specifying the femoral veins.
4. Bilateral Venous Embolism: This term highlights the embolic nature of the condition, where a clot travels and lodges in the femoral veins.

Related Terms

1. Acute Venous Thromboembolism (VTE): A broader term that encompasses both thrombosis and embolism in the venous system, including the femoral veins.
2. Thrombophlebitis: Inflammation of a vein due to a thrombus, which can occur in the femoral veins.
3. Embolism: A condition where a blood clot or other debris travels through the bloodstream and lodges in a vessel, which can include the femoral veins.
4. Venous Insufficiency: A condition that can lead to thrombosis, characterized by the inability of the veins to adequately return blood to the heart.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals involved in diagnosis, treatment, and billing processes. Accurate terminology ensures proper communication among medical staff and aids in the effective management of patients with this condition.

In summary, the ICD-10 code I82.413 is associated with various alternative names and related terms that reflect the nature of the condition, its location, and its implications in the broader context of venous health.

The diagnosis of ICD-10 code I82.413, which refers to acute embolism and thrombosis of the femoral vein, bilateral, involves several clinical criteria and diagnostic procedures. Understanding these criteria is essential for accurate coding and effective patient management. Below are the key components typically considered in the diagnosis:

Clinical Presentation

1. Symptoms: Patients may present with symptoms such as:
   - Swelling in the affected leg(s)
   - Pain or tenderness in the thigh or groin area
   - Changes in skin color (e.g., pallor or cyanosis)
   - Warmth or increased temperature in the affected area

2. Risk Factors: A thorough assessment of risk factors is crucial. These may include:
   - Recent surgery or trauma
   - Prolonged immobility (e.g., long flights or bed rest)
   - History of venous thromboembolism (VTE)
   - Certain medical conditions (e.g., cancer, heart disease)

Diagnostic Imaging

1. Ultrasound: The primary diagnostic tool for confirming thrombosis in the femoral vein is a duplex ultrasound. This non-invasive test can visualize blood flow and detect clots.

2. CT or MRI: In some cases, computed tomography (CT) or magnetic resonance imaging (MRI) may be utilized to provide a more detailed view of the venous system, especially if there is a suspicion of complications or if ultrasound results are inconclusive.

Laboratory Tests

1. D-dimer Test: Elevated levels of D-dimer, a fibrin degradation product, can indicate the presence of an abnormal blood clot. However, this test is not specific and should be interpreted in conjunction with clinical findings and imaging results.

2. Coagulation Studies: Assessing the patient's coagulation profile may help identify underlying conditions that predispose them to thrombosis.

Clinical Guidelines

1. Diagnostic Criteria: According to clinical guidelines, the diagnosis of acute embolism and thrombosis of the femoral vein typically requires:
   - Confirmation of the presence of a thrombus in the femoral vein via imaging.
   - Evidence of acute symptoms consistent with venous thrombosis.
   - Exclusion of other potential causes of the symptoms.

2. Bilateral Diagnosis: For the specific code I82.413, it is essential that both femoral veins are affected, which should be clearly documented in the patient's medical records.

Conclusion

In summary, the diagnosis of ICD-10 code I82.413 involves a combination of clinical evaluation, imaging studies, and laboratory tests to confirm the presence of acute embolism and thrombosis in both femoral veins. Accurate documentation of symptoms, risk factors, and diagnostic findings is critical for proper coding and treatment planning. If you have further questions or need additional information on this topic, feel free to ask!

When addressing the standard treatment approaches for ICD-10 code I82.413, which refers to acute embolism and thrombosis of the femoral vein, bilateral, it is essential to consider the clinical guidelines and practices that are typically employed in such cases. This condition involves the obstruction of blood flow in the femoral veins due to blood clots, which can lead to significant complications if not managed appropriately.

Initial Assessment and Diagnosis

Before treatment can begin, a thorough assessment is necessary. This typically includes:

• Clinical Evaluation: Patients often present with symptoms such as swelling, pain, and discoloration in the affected leg(s). A detailed medical history and physical examination are crucial.
• Imaging Studies: Non-invasive imaging techniques, such as ultrasound, are commonly used to confirm the presence of thrombus in the femoral veins. Other imaging modalities may include CT venography or MRI if necessary[1][2].

Standard Treatment Approaches

1. Anticoagulation Therapy

The cornerstone of treatment for acute venous thrombosis is anticoagulation therapy. This involves:

• Initial Anticoagulation: Patients are typically started on unfractionated heparin or low molecular weight heparin (LMWH), such as enoxaparin, to quickly reduce the risk of clot propagation and prevent further embolism[3][4].
• Long-term Anticoagulation: After initial treatment, patients may transition to oral anticoagulants, such as warfarin or direct oral anticoagulants (DOACs) like rivaroxaban or apixaban, for a duration that depends on the underlying risk factors and the presence of any provoking factors for thrombosis[5].

2. Thrombolytic Therapy

In cases where there is significant limb threat or extensive thrombosis, thrombolytic therapy may be considered. This involves the administration of medications that dissolve clots, such as tPA (tissue plasminogen activator). This approach is typically reserved for severe cases due to the associated risks of bleeding[6].

3. Mechanical Interventions

For patients who do not respond to anticoagulation or thrombolytic therapy, or in cases of severe thrombosis, mechanical interventions may be necessary:

• Thrombectomy: This surgical procedure involves the physical removal of the clot from the vein and may be performed in conjunction with thrombolytic therapy[7].
• Inferior Vena Cava (IVC) Filters: In patients with recurrent embolism despite anticoagulation or those who cannot tolerate anticoagulants, placement of an IVC filter may be indicated to prevent clots from reaching the pulmonary circulation[8].

4. Supportive Care

Supportive measures are also important in the management of acute venous thrombosis:

• Compression Therapy: Graduated compression stockings may be recommended to reduce swelling and prevent post-thrombotic syndrome[9].
• Pain Management: Analgesics may be prescribed to manage pain associated with the condition.

Follow-Up and Monitoring

Regular follow-up is essential to monitor the effectiveness of treatment and to adjust anticoagulation dosages as needed. Patients should be educated about the signs of potential complications, such as pulmonary embolism, and the importance of adherence to anticoagulation therapy.

Conclusion

The management of acute embolism and thrombosis of the femoral vein, particularly bilateral cases represented by ICD-10 code I82.413, involves a multifaceted approach that includes anticoagulation, potential thrombolytic therapy, mechanical interventions, and supportive care. Early diagnosis and treatment are critical to prevent complications and improve patient outcomes. Continuous monitoring and follow-up care are essential to ensure the effectiveness of the treatment plan and to mitigate the risk of recurrence.

For further information or specific case management, consulting with a vascular specialist is recommended.