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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I81

Billable / Specific MCC

Portal vein thrombosis

I81
Block
1
Synonyms
165
LCDs
13
Payer Policies
3
Linked CPTs

About ICD-10-CM I81

ICD-10-CM code I81 represents Portal vein thrombosis. This is a billable/specific code in the Circulatory System chapter (block I81). The 2026 edition of ICD-10-CM I81 became effective on October 1, 2025.

Coding Tips for I81

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: MCC

I81 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I81. Per CMS ICD-10-CM Tabular 2026.

  • Portal (vein) obstruction

Type 2 Excludes

Not included here, the excluded code is not part of I81, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • hepatic vein thrombosis (I82.0)
  • phlebitis of portal vein (K75.1)

Inpatient DRG Impact, MCC

codes Portal vein thrombosis. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for I81

Local Coverage Determinations (LCDs) from CMS MACs that list I81 as a covered diagnosis.

165 LCDs

Showing top 10 of 165 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
Article ID: 60271, Effective: , 98 covered, 0 non-covered
CPT 81241 →
CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
Article ID: 60271, Effective: , 98 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
Article ID: 60271, Effective: , 98 covered, 0 non-covered
CPT 81240 →
CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
Article ID: 60307, Effective: , 98 covered, 0 non-covered
CPT 81241 →
CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
Article ID: 60307, Effective: , 98 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia
Article ID: 60307, Effective: , 98 covered, 0 non-covered
CPT 81240 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88189 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86360 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86361 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88187 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I81.

13 policies

5 Medicare

Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Biomarkers Overview
Policy ID: ART-56541
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56697

CPT Codes Commonly Billed with I81

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

3 linkages
  • 81240 CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia CMS LCD
  • 81241 CMS LCD: Billing and Coding: MolDX: Genetic Testing for Hereditary Thrombophilia CMS LCD
  • 81490 CMS LCD: Billing and Coding: Biomarkers Overview CMS LCD

Convert I81 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I81 452 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To I81

Other codes in section I80-I89 (Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified).

I80 Phlebitis and thrombophlebitis (non-billable) I80.0 Phlebitis and thrombophlebitis of superficial vessels of lower extremities (non-billable) I80.00 Phlebitis and thrombophlebitis of superficial vessels of unspecified lower extremity I80.01 Phlebitis and thrombophlebitis of superficial vessels of right lower extremity I80.02 Phlebitis and thrombophlebitis of superficial vessels of left lower extremity I80.03 Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral I80.1 Phlebitis and thrombophlebitis of femoral vein (non-billable) I80.10 Phlebitis and thrombophlebitis of unspecified femoral vein I80.11 Phlebitis and thrombophlebitis of right femoral vein I80.12 Phlebitis and thrombophlebitis of left femoral vein I80.13 Phlebitis and thrombophlebitis of femoral vein, bilateral I80.2 Phlebitis and thrombophlebitis of other and unspecified deep vessels of lower extremities (non-billable) I80.20 Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities (non-billable) I80.201 Phlebitis and thrombophlebitis of unspecified deep vessels of right lower extremity I80.202 Phlebitis and thrombophlebitis of unspecified deep vessels of left lower extremity I80.203 Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities, bilateral I80.209 Phlebitis and thrombophlebitis of unspecified deep vessels of unspecified lower extremity I80.21 Phlebitis and thrombophlebitis of iliac vein (non-billable) I80.211 Phlebitis and thrombophlebitis of right iliac vein I80.212 Phlebitis and thrombophlebitis of left iliac vein

ICD-10 I81, Billing FAQ

Is ICD-10 code I81 billable? +

Yes, I81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I81? +

ICD-10 I81 includes: Portal (vein) obstruction.

What codes are Type 2 Excludes for I81? +

Type 2 Excludes (may be coded together when both conditions exist): hepatic vein thrombosis (I82.0); phlebitis of portal vein (K75.1)

Is I81 a CC or MCC for inpatient DRG? +

Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with I81? +

Procedures frequently paired with I81 include: 81240, 81241, 81490.

What ICD-9 codes does I81 map to? +

Per CMS GEMs, I81 maps to ICD-9 codes: 452. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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