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Chronic venous insufficiency of the lower limb G045

Last amended 
29 May 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
29 of 2012
Balance of Probabilities SOP
30 of 2012
Changes from Previous Instruments:

SOP Bulletin 157

ICD Coding:
  • ICD-9-CM Codes: 459.1.459.81
  • ICD-10-AM Codes: I87, I87.2

This SOP covers swelling, skin changes, ulcers and lipodermatosclerosis of the lower limbs due to impairment of venous blood flow.

Is specific diagnostic evidence required to apply the SOP?No. 
Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • Lipodermatosclerosis
  • Venous eczema of the lower limb
  • Venous ulcer of the lower limb
Conditions not covered by SOP
  • Deep vein thrombosis, ICD code 453.8
  • Varicose veins, ICD code 454
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Report from treating doctor.