Chronic embolism and thrombosis of unspecified axillary vein

This code signifies a persistent or long-standing blockage within an axillary vein due to a blood clot, where the specific side (left or right) is not documented. This condition can lead to impaired blood flow from the upper extremity, potentially causing swelling, pain, and functional limitations.

Apply this code when documentation clearly indicates a chronic, rather than acute, thrombotic or embolic event affecting an axillary vein, and the laterality is not specified. Supporting documentation would include imaging reports (e.g., ultrasound, venography) confirming chronic thrombosis and physician notes detailing the chronicity and location.

• Ensure documentation explicitly states "chronic" to differentiate from acute events.
• Avoid using this code if the laterality (left or right axillary vein) is specified; instead, use the more specific codes.
• Confirm the diagnosis is of the axillary vein and not another upper extremity vein to prevent miscoding.