ICD-10: I82.A13

The ICD-10 code I82.A13 refers to the clinical condition known as acute embolism and thrombosis of the axillary vein, specifically when it occurs bilaterally. This condition is part of a broader category of venous embolism and thrombosis, which can have significant implications for patient health and management.

Clinical Description

Definition

Acute embolism and thrombosis of the axillary vein involves the obstruction of blood flow in the axillary vein due to a thrombus (blood clot) or an embolus (a clot that has traveled from another location). When this condition is bilateral, it means that both axillary veins are affected, which can lead to more severe complications compared to unilateral cases.

Symptoms

Patients with acute embolism and thrombosis of the axillary vein may present with a variety of symptoms, including:
- Swelling: Noticeable swelling in the affected arm(s) due to fluid accumulation.
- Pain: Discomfort or pain in the shoulder or upper arm, which may worsen with movement.
- Color Changes: The skin may appear discolored, often becoming pale or bluish.
- Temperature Changes: The affected area may feel warmer or cooler compared to the other arm.

Risk Factors

Several factors can increase the risk of developing this condition, including:
- Prolonged Immobility: Situations such as long flights or bed rest can lead to venous stasis.
- Surgery: Recent surgical procedures, particularly those involving the upper body, can predispose individuals to thrombosis.
- Trauma: Injuries to the shoulder or upper arm can damage veins and lead to clot formation.
- Hypercoagulable States: Conditions that increase blood clotting, such as certain genetic disorders, pregnancy, or the use of hormonal contraceptives.

Diagnosis

Diagnosis typically involves a combination of clinical evaluation and imaging studies. Common diagnostic methods include:
- Ultrasound: A non-invasive imaging technique that can visualize blood flow and detect clots in the axillary vein.
- Doppler Studies: These assess the direction and speed of blood flow, helping to identify obstructions.
- CT or MRI: In some cases, advanced imaging may be required to evaluate the extent of the thrombosis.

Treatment

Management of acute embolism and thrombosis of the axillary vein may include:
- Anticoagulation Therapy: Medications such as heparin or warfarin are commonly used to prevent further clot formation.
- Thrombolysis: In severe cases, thrombolytic agents may be administered to dissolve the clot.
- Surgical Intervention: Rarely, surgical procedures may be necessary to remove the clot or repair damaged veins.

Conclusion

The ICD-10 code I82.A13 encapsulates a serious medical condition that requires prompt diagnosis and treatment to prevent complications such as post-thrombotic syndrome or pulmonary embolism. Understanding the clinical presentation, risk factors, and management strategies is crucial for healthcare providers in effectively addressing this condition and improving patient outcomes.

The ICD-10 code I82.A13 refers to "Acute embolism and thrombosis of axillary vein, bilateral." This condition involves the obstruction of the axillary veins, which can lead to significant clinical implications. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Acute embolism and thrombosis of the axillary vein can manifest in various ways, often depending on the severity and duration of the condition. Patients may present with:

• Swelling: One of the most common signs is swelling of the affected arm, which may be unilateral or bilateral depending on the extent of the thrombosis.
• Pain: Patients often report pain in the shoulder or upper arm, which may be described as a deep ache or sharp pain.
• Discoloration: The skin over the affected area may appear discolored, often presenting as a bluish or reddish hue due to impaired venous return.
• Warmth: The affected area may feel warm to the touch, indicating inflammation or increased blood flow in response to the obstruction.

Signs and Symptoms

The signs and symptoms of acute embolism and thrombosis of the axillary vein can include:

• Pitting Edema: Swelling that leaves an indentation when pressed.
• Reduced Pulsation: Diminished or absent pulse in the affected arm, indicating compromised blood flow.
• Venous Distension: Prominent veins may be visible on the surface of the skin due to increased venous pressure.
• Numbness or Tingling: Patients may experience neurological symptoms such as numbness or tingling in the arm, which can occur if the thrombosis compresses nearby nerves.

Patient Characteristics

Certain patient characteristics may predispose individuals to develop acute embolism and thrombosis of the axillary vein:

• Age: Older adults are at a higher risk due to age-related vascular changes.
• Obesity: Increased body mass index (BMI) can contribute to venous stasis and thrombosis.
• Sedentary Lifestyle: Prolonged immobility, such as long flights or bed rest, can increase the risk of thrombus formation.
• History of Thrombosis: A personal or family history of venous thromboembolism can elevate risk.
• Underlying Conditions: Conditions such as cancer, autoimmune disorders, or hypercoagulable states (e.g., Factor V Leiden mutation) can predispose individuals to thrombosis.

Conclusion

Acute embolism and thrombosis of the axillary vein, classified under ICD-10 code I82.A13, presents with a range of clinical signs and symptoms, including swelling, pain, and discoloration of the affected arm. Patient characteristics such as age, obesity, and a history of thrombosis play a significant role in the risk of developing this condition. Early recognition and management are essential to prevent complications, including chronic venous insufficiency or post-thrombotic syndrome. If you suspect this condition, prompt medical evaluation and intervention are critical.

The ICD-10 code I82.A13 refers specifically to "Acute embolism and thrombosis of axillary vein, bilateral." This condition involves the obstruction of the axillary vein due to a blood clot (thrombus) or an embolus, which can lead to significant complications if not addressed promptly. Below are alternative names and related terms that can be associated with this condition:

Alternative Names

1. Bilateral Axillary Vein Thrombosis: This term emphasizes the presence of a thrombus in both axillary veins.
2. Bilateral Axillary Vein Embolism: This highlights the occurrence of an embolus affecting both axillary veins.
3. Bilateral Upper Extremity Venous Thrombosis: A broader term that includes thrombosis in the axillary veins as part of the upper extremity venous system.
4. Bilateral Axillary Venous Occlusion: This term describes the blockage of the axillary veins, which can be due to thrombosis or embolism.

Related Terms

1. Deep Vein Thrombosis (DVT): While DVT typically refers to thrombosis in the deep veins of the legs, it can also encompass similar conditions in the upper extremities, including the axillary veins.
2. Venous Thromboembolism (VTE): This term encompasses both thrombosis and embolism in the venous system, which can include the axillary veins.
3. Thromboembolic Disease: A general term that refers to conditions caused by blood clots that can lead to embolism.
4. Acute Venous Occlusion: A term that can refer to any acute blockage in the venous system, including the axillary veins.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and coding conditions related to venous thrombosis and embolism. Accurate coding is essential for treatment planning, billing, and epidemiological tracking of such conditions.

In summary, the ICD-10 code I82.A13 can be referred to by various alternative names and related terms that reflect the nature of the condition and its clinical implications. These terms help in ensuring clear communication among healthcare providers and in the documentation of patient records.

The diagnosis of acute embolism and thrombosis of the axillary vein, particularly when classified under ICD-10 code I82.A13, involves a comprehensive evaluation based on clinical criteria, imaging studies, and patient history. Below is a detailed overview of the criteria typically used for this diagnosis.

Clinical Presentation

1. Symptoms: Patients may present with symptoms such as:
   - Swelling of the arm or shoulder on the affected side.
   - Pain or tenderness in the shoulder or upper arm.
   - Changes in skin color (e.g., pallor or cyanosis) in the affected area.
   - Warmth or increased temperature in the affected limb.
   - Reduced range of motion in the shoulder or arm.

2. Risk Factors: Identifying risk factors is crucial. Common risk factors for venous thrombosis include:
   - Prolonged immobility (e.g., long flights, bed rest).
   - Recent surgery, particularly orthopedic or abdominal procedures.
   - History of venous thromboembolism (VTE).
   - Cancer or active malignancy.
   - Hormonal therapy or pregnancy.
   - Obesity and advanced age.

Diagnostic Imaging

1. Ultrasound: The primary imaging modality for diagnosing axillary vein thrombosis is a non-invasive vascular ultrasound. This test can help visualize:
   - The presence of thrombus (clot) within the axillary vein.
   - Changes in blood flow patterns, indicating obstruction.

2. Doppler Studies: Doppler ultrasound can assess blood flow in the axillary vein and confirm the presence of thrombosis by showing reduced or absent venous flow.

3. 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 vascular structures and to rule out other conditions.

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 can help identify underlying conditions that predispose to thrombosis, such as antiphospholipid syndrome or inherited thrombophilia.

Clinical Guidelines

1. Diagnostic Criteria: According to clinical guidelines, the diagnosis of acute embolism and thrombosis of the axillary vein is typically confirmed when:
   - Clinical symptoms are present.
   - Imaging studies confirm the presence of a thrombus in the axillary vein.
   - Other potential causes of the symptoms have been ruled out.

2. Differential Diagnosis: It is essential to differentiate axillary vein thrombosis from other conditions that may present similarly, such as:
   - Thoracic outlet syndrome.
   - Musculoskeletal injuries.
   - Lymphatic obstruction.

Conclusion

The diagnosis of acute embolism and thrombosis of the axillary vein (ICD-10 code I82.A13) relies on a combination of clinical evaluation, imaging studies, and laboratory tests. A thorough assessment of symptoms, risk factors, and appropriate diagnostic imaging is essential for accurate diagnosis and subsequent management. If you suspect this condition, it is crucial to consult a healthcare professional for a comprehensive evaluation and treatment plan.

Acute embolism and thrombosis of the axillary vein, classified under ICD-10 code I82.A13, is a serious condition that requires prompt and effective treatment. This condition typically involves the formation of a blood clot in the axillary vein, which can lead to significant complications if not addressed. Below is a detailed overview of standard treatment approaches for this condition.

Understanding Acute Embolism and Thrombosis of the Axillary Vein

Acute embolism and thrombosis of the axillary vein can occur due to various factors, including prolonged immobility, trauma, certain medical conditions, or the presence of central venous catheters. Symptoms may include swelling, pain, and discoloration of the affected arm, and in severe cases, it can lead to complications such as pulmonary embolism.

Standard Treatment Approaches

1. Anticoagulation Therapy

The primary treatment for acute venous thrombosis is anticoagulation therapy. This involves the use of medications that prevent further clot formation and allow the body to gradually dissolve the existing clot. Common anticoagulants include:

• Heparin: Often administered intravenously in a hospital setting for immediate effect.
• Low Molecular Weight Heparin (LMWH): Such as enoxaparin, which can be given subcutaneously and is often used for outpatient management.
• Oral Anticoagulants: After initial treatment, patients may transition to oral anticoagulants like warfarin or direct oral anticoagulants (DOACs) such as rivaroxaban or apixaban for long-term management[1][2].

2. Thrombolytic Therapy

In cases where there is a significant risk of complications or if the patient presents with severe symptoms, thrombolytic therapy may be considered. This involves the administration of drugs that dissolve clots, such as tissue plasminogen activator (tPA). Thrombolytics are typically used in more severe cases or when there is a need for rapid resolution of the clot[3].

3. Mechanical Thrombectomy

For patients who do not respond to anticoagulation or thrombolytic therapy, or in cases of extensive thrombosis, mechanical thrombectomy may be performed. This minimally invasive procedure involves the removal of the clot using specialized devices. It is often done in conjunction with imaging techniques to guide the procedure[4].

4. Compression Therapy

In addition to pharmacological treatments, compression therapy may be recommended to reduce swelling and improve venous return. This can involve the use of compression stockings or bandages, which help to support the affected limb and prevent further complications[5].

5. Monitoring and Follow-Up

Patients diagnosed with acute embolism and thrombosis of the axillary vein require careful monitoring. Regular follow-up appointments are essential to assess the effectiveness of treatment, manage any side effects of anticoagulation, and monitor for potential complications such as post-thrombotic syndrome[6].

6. Lifestyle Modifications

Patients are often advised to make lifestyle changes to reduce the risk of future thrombotic events. This may include:

• Increasing physical activity to improve circulation.
• Staying hydrated, especially during long periods of immobility.
• Avoiding smoking, which can increase the risk of clot formation[7].

Conclusion

The management of acute embolism and thrombosis of the axillary vein involves a multifaceted approach that includes anticoagulation therapy, potential thrombolytic or mechanical interventions, and supportive measures such as compression therapy. Close monitoring and lifestyle modifications are also crucial in preventing recurrence. As always, treatment should be tailored to the individual patient's needs and circumstances, and decisions should be made in consultation with a healthcare provider.

References

1. Billing and Coding: Non-Invasive Peripheral Venous Studies.
2. Medicare Claims Processing Manual.
3. Final Draft Report Thromboembolic Event Case Algorithms.
4. Noninvasive Peripheral Venous Studies.
5. Venous Duplex Ultrasound of the Upper Extremities.
6. Measure Specifications for FY17 IRF QRP Final Rule.pdf.
7. Concordance of Identified Cases of Pediatric HA-VTE with ...