Septic arterial embolism
In Diseases of arteries, arterioles and capillaries (I70-I79), chapter 9: Diseases of the Circulatory System
- I76 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under I70-I79 below.
- As a secondary diagnosis it is a CC (complication or comorbidity), which can raise the MS-DRG payment. It doesn't count when the principal diagnosis is one of 63 closely related codes.
- Counts toward HCC 264 (Vascular Disease with Complications) in the Medicare Advantage risk model (CMS-HCC V28).
- AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
- Medicare edits don't accept it as the principal diagnosis. (Unacceptable Principal list)
Also indexed as: Embolism, artery, septic; Embolism, pyemic; Embolism, septic
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Instructional notes
Excludes2: not included here, code separately if applicable
Code first: code the underlying condition first, then this code
Use additional code: add a second code for this, listed after this one
- code to identify the site of the embolism (I74.-)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers hypertension with heart and kidney disease, coronary artery disease with angina, perioperative stroke, cerebrovascular sequelae, and acute myocardial infarction types and timing.
- Hypertension (page 50)
- Atherosclerotic Coronary Artery Disease and Angina (page 52)
- Intraoperative and Postprocedural Cerebrovascular Accident (page 53)
- Sequelae of Cerebrovascular Disease (page 53)
- Acute myocardial infarction (AMI) (page 54)
Other codes under I70-I79
Diseases of arteries, arterioles and capillaries (I70-I79)
- I70Atherosclerosis
- I71Aortic aneurysm and dissection
- I72Other aneurysm
- I73Other peripheral vascular diseases
- I74Arterial embolism and thrombosis
- I75Atheroembolism
- I76Septic arterial embolism(this code)
- I77Other disorders of arteries and arterioles
- I78Diseases of capillaries
- I79Disorders of arteries, arterioles and capillaries in diseases classified elsewhere
I76 MS-DRGs
As the principal diagnosis, I76 groups to MS-DRG 299, 300, 301, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
I76 is in Aortic and peripheral arterial embolism or thrombosis (CIR030), with 22 codes. Others in it:
- I74.01 Saddle embolus of abdominal aorta
- I74.09 Other arterial embolism and thrombosis of abdominal aorta
- I74.10 Embolism and thrombosis of unspecified parts of aorta
- I74.11 Embolism and thrombosis of thoracic aorta
- I74.19 Embolism and thrombosis of other parts of aorta
- I74.2 Embolism and thrombosis of arteries of the upper extremities
- I74.3 Embolism and thrombosis of arteries of the lower extremities
- I74.4 Embolism and thrombosis of arteries of extremities, unspecified
I76 is in Bacterial infections (INF003), with 398 codes. Others in it:
Medicare coverage articles listing I76
These 12 Medicare billing and coding articles list I76 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
- Transesophageal Echocardiography (TEE) (3 contractors)
- Magnetic Resonance Angiography (MRA) (2 contractors)
- Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (2 contractors)
- Non-Invasive Vascular Studies (2 contractors)
- Transthoracic Echocardiography (TTE) (2 contractors)
- Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities
- MRI and CT Scans of the Head and Neck
- Magnetic Resonance Angiography
- Non-Invasive Abdominal / Visceral Vascular Studies
- Non-Invasive Cerebrovascular Arterial Studies
And 2 more.
Other codes that refer to I76
Notes on these codes point to I76.
Code history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 449 Septic arterial embolism