329 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The code is valid. What is the ICD-10 code for chronic venous insufficiency? ICD-10 code: I87. If this condition is not treated. 333 is a valid billable ICD-10 diagnosis code for Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity . Stasis ulcers are most likely caused by inadequate venous circulation in the area, so that is why it's classified this way. Short description: Chronic venous hypertension w ulcer of r low extrem; The 2024 edition of ICD-10-CM I87. 501 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. #1. 323 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with inflammation of bilateral lower extremity. E05. 33 became effective on October 1, 2023. National Coverage. 319 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Use this page to view details for the Local Coverage Article for Billing and Coding: Treatment of Chronic Venous Insufficiency of the Lower Extremities. 333 is a valid billable ICD-10 diagnosis code for Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity . 5190 [convert to ICD-9-CM] Maternal care for known or suspected placental insufficiency, unspecified trimester, not applicable or unspecified. What is the ICD-10 code for diabetes with venous insufficiency? Type 2 diabetes mellitus with other circulatory complications. Applicable To. Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity. 2 became effective on October 1, 2023. 1. This is the American ICD-10-CM version of I83. N Engl J Med 2009; 360:2319-2327 DOI: 10. post. This is the American ICD-10-CM version of I87. K55. #1. 2 (chronic) (peripheral) ICD-10-CM Diagnosis Code I87. This is the American ICD-10-CM version of I50. (Am Fam. 8, other specified congenital malformations of peripheral vascular system) only applies to the foam sclerotherapy CPT. When chronic venous insufficiency is the cause, other manifestations usually include varicose veins, purpura jaune d'ocre (a yellow-brown discoloration due hemosiderin deposits in the dermis), and lipodermatosclerosis (sclerosis of subcutaneous fat caused by panniculitis Panniculitis Panniculitis describes inflammation of the subcutaneous fat that. I50. 303 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) without complications of bilateral lower extremity. Yet, the incidence and severity of peripheral venous hypertension in the clinical setting have not been reported. INTRODUCTION. 9 may differ. ICD-10-CM Diagnosis Code O36. Venous diseases affect more than half of the population of developed countries. Lymphedema is a chronic disease marked by the increased collection of lymphatic fluid in the body, causing swelling, which can lead to skin and tissue changes. Showing 1-25: ICD-10-CM Diagnosis Code O10. 9 may differ. Applicable To. Search All ICD-10 Toggle Dropdown. J Vasc Surg1995 Nov;22 (5):622-8. 9 may differ. Applicable To. 501 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Venous leg ulcers (VLUs) include about 70% of all leg ulcers and affect 2. Immobility including lack of physical exercise and paralysis. This most commonly results from venous reflux due to faulty valve function developing as a long-term sequela of deep vein thrombosis (DVT) and recanalization, and may also develop. Chronic (presentation of) coronary microvascular disease; Coronary microvascular dysfunction NOS. Guidelines Summary. #1. 0. . 332. 32) I87. This is caused by: Incompetent venous valves. 813 became effective on October 1, 2023. I87. 1 In 2015, the Wound, Ostomy and Continence Nurses (WOCN) Society appointed a task force to develop an algorithm for VLUs to address the need for clinical guidance on. The following ICD-10 code(s) have undergone a descriptor change: I83. People who have chronic venous insufficiency can experience swelling and pain in the legs and ankles, as well as cramping, skin changes, and the development of varicose veins and skin ulcers. Chronic venous insufficiency occurs when the heart cannot pump blood from the leg veins back to the heart. I87. Short description: Chronic venous hypertension w ulcer of l low extrem; The 2024 edition of ICD-10-CM I87. One of the most common circulatory disorders is venous insufficiency, which is also commonly associated with bilateral leg edema. 311 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. E11. 2. 2 Venous insufficiency (chronic) (peripheral) - icdcode. Showing 1-25: ICD-10-CM Diagnosis Code I67. Venous insufficiency can be caused by aging, but it can also signal a serious underlying medical condition, such as heart or kidney disease. Family history of this condition. 399 became effective on October 1, 2023. . The implant stops blood from flowing. 10 may differ. I am only finding I87. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Acute dacryopericystitis. I87. Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified. 332 became effective on. 3 Chronic venous hypertension (idiopathic). doi: 10. Introduction. Incompetent valve in the superficial, perforating, and deep systems. 31) I87. 319 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. When chronic venous insufficiency is the cause, other manifestations usually include varicose veins, purpura jaune d'ocre (a yellow-brown discoloration due hemosiderin deposits in the dermis), and lipodermatosclerosis (sclerosis of subcutaneous fat caused by panniculitis Panniculitis Panniculitis describes inflammation of the subcutaneous fat that. I37. I87. Sep 8, 2016. clevelandclinic. 3 ICD-10 code I87. Normally, the valves in your veins make sure that blood flows toward your heart. This is caused by: Incompetent venous valves. 33 may differ. 79 - other international versions of ICD-10 Z86. 2: Venous Insufficiency (Chronic) (Peripheral). 31 - other international versions of ICD-10 I87. Other ICD-10-CM Codes Commonly Used for Similar Conditions Filter related codes list: I87 Other disorders of veins. long-standing chronic venous insufficiency. Peripheral artery disease (PAD) and chronic venous insufficiency (CVI) both affect your blood vessels and prevent your body from getting the oxygen-rich blood that it needs. I87. ICD-10-CM Codes. Chronic venous hypertension (idiopathic) I87. 2) Venous insufficiency (chronic) (peripheral) I87. 03 [convert to ICD-9-CM] Pre-existing essential hypertension complicating the puerperium. 00 Complete placenta previa NOS or without hemor. External compression of veins. •I87. 30 Chronic venous hypertension (idiopathic) without complications I83. 8, E07. K55. Pada penderita chronic venous insufficiency, katup pada pembuluh darah. Chronic venous insufficiency can be caused by: Venous factors. CPT code 37241 is not appropriate for reporting of vein ablation for the treatment of chronic venous insufficiency of the lower extremities and is incorrect coding. Conservative management for chronic venous insufficiency (Noninvasive procedures). 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. E05. 2. 12 (I95–I99) Other and unspecified disorders of the circulatory system. 3 or Varix ulcers I83. Physical findings include abnormal venous dilation (ie, telangiectasias-corona phlebectatica, reticular veins, varicose veins), edema, inflammation, dermatitis, skin changes, and ulceration. Classes C3 and above (according to the CEAP classification) are designated as chronic venous insufficiency (CVI) (see clinical features and classification), which – by definition – is associated with. 323 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with inflammation of bilateral lower extremity. Dysfunction of the calf muscle pump [2]. chronic venous insufficiency, whereas it is the only clinical feature of chronic venous insufficiency in about 10% of patients. 313 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Varicose veins are commonly found among people who stand on their. (CT) to assess the venous insufficiency or valve failure[10-12]. ” 5 The authors classified the diagnosis codes into 2 categories: (1) pain, swelling, and inflammation, and (2) ulceration. The code I87. For example, ICD-10 code I87393 is “chronic venous hypertension (idiopathic) with other complications of bilateral lower extremity. ICD 10 code for Chronic embolism and thrombosis of unspecified deep veins of lower extremity. 2 became effective on October 1, 2023. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. ICD-10-CM Diagnosis Code I73. 333 Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity. Toggle navigation. I87. Chronic venous insufficiency (CVI) refers to functional changes that may occur in the lower extremity due to persistent elevation of venous pressures. I87. 8. This is the American ICD-10-CM version of I83. 301 became effective on October 1, 2023. Beberapa jenis obat yang dapat dikonsumsi untuk mengatasi chronic venous insufficiency meliputi: Obat pengencer darah, untuk mencegah pembentukan gumpalan darah. 322. Venous reflux occurs when venous valves don't function adequately. 331 became effective on October 1, 2023. Rules. I know that anything that falls under the "with" in the alphabetic index for diabetes is an assumed relationship and should be coded as such. Chronic venous hypertension (idiopathic) with ulcer and inflammation of left lower. I87. Background: Microvascular venous hypertension has emerged as a central feature of chronic venous disease (CVD). ICD-10 | Venous insufficiency (chronic) (peripheral) (I87. Other specified disorders of veins. ICD-10-CM Diagnosis Code I87. Short description: Chronic venous hypertension w ulcer of r low extrem. Pain should be assessed with the use of a vi-maternal care for poor fetal growth due to placental insufficiency (ICD-10-CM Diagnosis Code O36. The condition results from venous hypertension which in turn is usually caused by reflux in the superficial venous compartment. Hemosiderin is a brownish pigment caused by the breakdown of blood. Conservative management for chronic venous insufficiency (Noninvasive procedures). . Other disorders of veins (I87) Disorder of vein, unspecified (I87. :846 They are the major occurrence of chronic wounds, occurring in 70% to 90% of leg ulcer cases. 333. Established dogma purports that cancer is the most common cause of lower extremity lymphedema in Western countries, whereas chronic venous insufficiency (CVI) is often overlooked as a potential cause. The following ICD-10 code(s) have undergone a descriptor change: I83. I87. 2 View ICD-10 Tree Chapter 9 - Diseases of the circulatory. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. -) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere. Venous Stasis Dermatitis. 2 Most admissions are for venous ulcers, the most advanced clinical manifestation of the disease, occurring in approximately 20,550 patients each. The 2022 edition of ICD-10-CM E11. 621 DM with foot ulcer •L97. Chronic venous hypertension (idiopathic) with ulcer and inflammation of right lower extremity: I87. 013 Varicose veins of right lower extremity with ulcer of. 800. CEAP classification was then adopted worldwide, providing a universally understandable description, and it became an instrument to. 9 became effective on October 1, 2023. DVT is the primary cause of pulmonary. ICD-10-CM Codes. Less common causes include: deep venous compression. I87. Chronic Venous Insufficiency (CVI) is a cause of abnormalities of the venous system producing edema, skin changes, or venous ulcers that is associated with varicose veins. 79 became effective on October 1, 2023. Chronic venous hypertension (idiopathic) with ulcer. 03 [convert to ICD-9-CM] Combined arterial insufficiency and corporo- venous occlusive erectile dysfunction. 322. I87. Chronic deep venous thrombosis of lower extremity due to coronary artery bypass graft;Search Results. Peripheral vasodilators. 0 Complete placenta previa NOS or without hemor. Family history of this condition. Treatment can include wearing compression stockings. I87. Previous deep vein thrombosis. 312 became effective on October 1, 2023. This is an observational study of venous hypertension in the lower limb of a large cohort of patients with suspected CVD. ICD-10-CM Diagnosis Code I15. 399 - other international versions of ICD-10 I87. The 2024 edition of ICD-10-CM K55. [1][2][3][4] In normal conditions, calf muscle contraction and intraluminal valves promote prograde flow while preventing blood reflux. What is the ICD-10 code for diabetes with venous insufficiency? Type 2 diabetes mellitus with other circulatory complications. LCD revised and published on 10/05/2017 effective for dates of service on and after 10/01/2017 to reflect the ICD-10 Annual Code Updates. Nonrheumatic pulmonary valve stenosis with insufficiency. However, there is no definitive stepwise progression from spider veins to. 1 Although swelling is consistent with C3 and inflammation could be considered C4a and. Chronic Venous Insufficiency (CVI) is a cause of abnormalities of the venous system producing edema, skin changes, or venous ulcers that is associated with varicose veins. 2 Chronic venous Insufficiency. Chronic venous insufficiency is a progressive disease that spans several unique presentations, from spider veins and leads to varicose veins, eczema, atrophie blanche, corona phlebectatics, & venous ulcers in the late stages. 9 - other international versions of ICD-10 I50. 2 is a billable diagnosis code for venous insufficiency (chronic) (peripheral), a condition of inadequate blood flow through a vein. % of Total ICD I872 - Venous insufficiency (chronic) (peripheral) in DRG: 10. S. . Dependent edema is more common in venous insufficiency, which usually improves with elevation and worsens with dependency. 0): 299 Peripheral vascular disorders with mcc;The pathophysiology may actually be a combination of factors with spider veins being on the milder side of the chronic venous insufficiency spectrum and varicose veins at the more severe end. 51 DM with peripheral angiopathyRuscus extract and horse chestnut seed demonstrate moderate-quality evidence to improve edema from chronic venous insufficiency. Pembuluh darah memiliki katup yang menjaga aliran darah tetap ke satu arah, yaitu ke jantung. ; Venous stasis edema with ulcer of ankle; Venous stasis edema with ulcer of ankle, bone necrosis; Venous stasis edema with ulcer of ankle, muscle necrosis; Venous stasis. Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified. Introduction. [ 21] Clinical classification is as follows: C0 - No visible signs of venous disease. 1,2 Varicose veins of the lower extremities are a manifestation of chronic venous disease (CVD) and are a common disorder in the United States. L97. 1 became effective on October 1, 2023. 00 Postthrombotic syndrome without complications. Short description: Chronic venous hypertension w/o comp of r low extrem; The 2024 edition of ICD-10-CM I87. Results The proportion of the population suffering from lower limb venous disease and obesity is increasing. I am looking for some guidance on coding Chronic Venous Hypertension Ulcers I87. I87. 1056/NEJMcp0802444. Stasis ulcers most commonly occur at the medial malleolus, but any part of the. 8, other specified congenital. This free tool is designed to help billers and coders navigate the new ICD-10-CM code set. Diseases of the circulatory system. 3. I87. Obat-obatan. The above description is abbreviated. Chronic venous hypertension w inflammation of l low extrem; Peripheral venous htn, chronic, inflamed, left; Stasis dermatitis of left lower extremity due to peripheral venous hypertension. •The ICD-10-CM conventions presume a cause and effect relationship even in the absence of physician documentation when the words with [ or in [ are used in the index or in the title. Dependent edema is more common in venous insufficiency, which usually improves with elevation and worsens with dependency. I87. I37. 2) Search Results. It may also occur as the result of a past blood clot in the legs. 3 or Varix ulcers I83. The 7 Stages of the CEAP Classification System. *The venous malformations ICD-10-CM diagnosis code (Q27. , from a pig) cardiac valve—into the femoral vein in the thigh. I83. N Engl J Med 2009; 360:2319-2327 DOI: 10. 2 (Venous insufficiency (chronic) (peripheral)). Acute (reversible) ischemia of intestine, part and extent unspecified. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code L97. 301 became effective on October 1, 2023. Codes. I83. 10 - other international versions of ICD-10 I83. . 621,. Showing 26-50: ICD-10-CM Diagnosis Code I87. The 2024 edition of ICD-10-CM Z86. Lymphedema of lower extremities is frequently associated with chronic venous insufficiency (CVI) in a. If the provider documents in the note that a patient has diabetes, and then also. I87. Best answers. The cause is often chronic venous insufficiency. This pressure leads to skin discoloration, pain, itching and sores. For example, ICD-10 code I87393 is “chronic venous hypertension (idiopathic) with other complications of bilateral lower extremity. If the provider documents in the note that a patient has diabetes, and then. 67: Readmission Rate at DRG: 16. 3 Chronic venous hypertension (idiopathic). Compression therapy is effective for most causes of edema. Obat-obatan. 31-, I87. 8. Explore this short guide to the ICD-10 code used for venous insufficiency and learn more about the code’s billability, synonyms, and clinical descriptions. 323 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with inflammation of bilateral lower extremity. 059. 891, I83. ICD-10 Games Learn codes with classic games like Flashcards and Hangman. Stasis dermatitis of left lower extremity due to peripheral venous hypertension; ICD-10-CM I87. 319 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity. 332 became effective on October 1, 2023. 07: Avg LOS at DRG: 3. Further, though treatment guidelines for chronic venous disease (CVD) are regularly updated, a range of signs and symptoms are. ICD-10 I87. I87. 319 became effective on October 1, 2023. Conservative management for chronic venous insufficiency (Noninvasive procedures). I87. Chronic venous insufficiency affects up to 5% of people in the US. Short description: Chronic venous hypertension w ulcer of r low extrem. SD is a cutaneous manifestation of venous hypertension that is the result of underlying chronic venous insufficiency [1, 2]. Jan 21, 2020. I87. ICD-10 code I87. However, varicose veins (VVs) are the most common manifestation of CVD. It is part of the Diagnostic Related Group (MS-DRG) 301 and has annotations for other codes. 2 is a billable/specific code for venous insufficiency (chronic) (peripheral), a condition of stasis dermatitis with ulceration of the lower extremities. 10 Varicose veins with great saphenous reflux International Classification of Diseases for Mortality and Morbidity Statistics, 11th Revision, v2023-01. Incompetent valves in the deep venous network allow retrograde blood flow, and eventually, blood pools in the small superficial vessels. At first, CVI causes very few, if any, symptoms and can be hard to spot. The chronic accumulation of more generalized edema over days, weeks, and months is usually due to underlying systemic conditions like congestive heart failure (CHF), liver disease, and renal disease. 1 Introduction. 311 Chronic venous hypertension (idiopathic) with ulcer of right lower extremity. Short description: Chronic venous hypertension w ulcer and inflammation The 2024 edition of ICD-10-CM I87. 500 results found. ICD 10 code for Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of muscle. 311 became effective on October 1, 2023. 2 [convert to ICD-9-CM] Venous insufficiency (chronic) (peripheral) Dermatitis stasis; Diabetes type 2 with statis ulcer; Peripheral venous insufficiency; Stasis dermatitis; Stasis dermatitis without varicosities; Stasis ulcer due to type 2 diabetes mellitus; Stasis ulcer of leg. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code I87. 2 [convert to ICD-9-CM] Venous insufficiency ( chronic) (peripheral) Dermatitis stasis; Diabetes type 2 with statis ulcer; Peripheral venous insufficiency; Stasis dermatitis; Stasis dermatitis without varicosities; Stasis ulcer due to type 2 diabetes mellitus; Stasis. The following code(s) above I83. Chronic venous insufficiency is associated with chronic disability, diminished quality of life, and high health care costs [ 5-9 ]. Gatal-gatal maupun stasis dermatitis. 899. The following ICD-10 code(s) have undergone a descriptor change: I83. . Postphlebitic syndrome may affect 20 to 50% of patients with deep venous thrombosis Deep Venous Thrombosis (DVT) Deep venous thrombosis (DVT) is clotting of blood in a deep vein of an extremity (usually calf or thigh) or the pelvis. Chronic venous insufficiency occurs when your leg veins don’t allow blood to flow back up to your heart. 4 min read. 59 Type 2 diabetes mellitus with other circulatory complications. 9 may differ. Acute dacryocystitis. The 2024 edition of ICD-10-CM I50. Conservative management for chronic venous insufficiency (Noninvasive procedures). Venous hypertension as a result of venous reflux (incompetence) or obstruction. Among patients presenting with acute proximal DVT (<14 days duration), MTS should be suspected if there are risk factors such as young age, female sex, oral contraceptive intake, left lower limb involvement, etc. Compression therapy is effective for most causes of edema. Venous ulcers (venous insufficiency ulceration, stasis ulcers, stasis dermatitis, varicose ulcers, or ulcus cruris) are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs (hence leg ulcers). Chronic venous insufficiency is a common condition that affects up to 40 percent of people in the United States. 2 Venous insufficiency (chronic) (peripheral) I87. 0-); varicose veins of lower extremities (I83. Physical findings include abnormal venous dilation (ie, telangiectasias-corona phlebectatica, reticular veins, varicose veins), edema, inflammation, dermatitis, skin changes, and ulceration. 8. 9 [convert to ICD-9-CM] Peripheral vascular disease, unspecified. I50. Untreated venous insufficiency in the deep or superficial system causes a progressive syndrome (chronic venous insufficiency. 302 became effective on October 1, 2023. Lipodermatosclerosis is classically found on the inner aspect of the lower extremities above the ankle. What ICD-10 Codes are Used for Venous Insufficiency. Venous reflux disease (VRD), also known as chronic venous insufficiency (CVI), occurs when veins fail to return blood to the heart properly. Short description: Chronic venous hypertension w/o comp of l low extrem; The 2024 edition of ICD-10-CM I87. It happens when there’s blood flow problems in your pelvic and ovarian veins. 909. Like other vein diseases, superficial venous insufficiency is often a. Superficial venous insufficiency manifests across the entire clinical spectrum from dilated veins (telangiectasias, reticular veins, varicose veins) to chronic venous stasis skin changes or venous leg ulceration. 2 is VALID for claim submission. 2 ICD-10 Billable. 1 may differ. CVI is a relatively common medical problem but is often overlooked by healthcare providers because of an underappreciation of the. 8 [convert to ICD-9-CM] Other specified acute skin changes due to ultraviolet radiation. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code I87. E11. All neoplasms, whether functionally active or not, are classified in Chapter 2. 89 [convert to ICD-9-CM] Other forms of chronic ischemic heart disease. Use Additional Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. Chronic venous insufficiency affects up to 5% of people in the US. 319 became effective on October 1, 2023. Search Results. 8. 0. 8 for Other specified disorders of veins is a medical classification as listed by WHO under the range -Diseases of veins, lymphatic ve. S. Best answers. This can manifest as dilated (but not varicose) superfical veins on the foot and ankle and various skin changes (pigmentation; exczema like changes; lipodermatosclerosis, which is inflammation and scarring of the fat layer under the skin with hardening. Incompetent valve in the superficial, perforating, and deep systems. 9. Postthrom syndrome w ulcer and inflam of unsp low extrm; Postthrombotic ulcer with inflammation; Stasis. The 2024 edition of ICD-10-CM I37. Dystrophic calcification (DC) is a form of local calcium deposits in dead or degraded tissues; although calcium deposits exist in the wound, the serum calcium and phosphorus levels are normal. O44. Short description: Chronic venous htn w ulcer and inflammation of l low extrem; The 2024 edition of ICD-10-CM I87. , Subsection 43, “Ligation procedures of the lower extremity (e. I am looking for some guidance on coding Chronic Venous Hypertension Ulcers I87. 223. Chronic venous insufficiency (CVI) is a medical condition in which the veins cannot pump enough blood back to the heart. Varicose veins are superficial veins in the subcutaneous tissue that become enlarged upon standing and are a common manifestation of underlying chronic venous disease. in a Diabetic patient. ICD-10-CM Diagnosis Code K55. 8) I87. 399. 0 Complete placenta previa NOS or without hemor.