Gangrene, not elsewhere classified
In Other and unspecified disorders of the circulatory system (I95-I99), chapter 9: Diseases of the Circulatory System
- I96 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under I95-I99 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 45 closely related codes.
- Counts toward HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) 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).
Also indexed as: Acrosphacelus; Gangrene; Gangrene, abdomen; Gangrene, auricle; Gangrene, cutaneous, spreading; Gangrene, extremity; Gangrene, limb; Gangrene, perineum; Gangrene, spine; Gangrene, spreading cutaneous; Gangrene, umbilicus; Necrosis, skin or subcutaneous tissue NEC; Noma, auricle
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Instructional notes
Includes: conditions that are coded here
- Gangrenous cellulitis
Excludes1: not coded here, use a different code
- gangrene in atherosclerosis of native arteries of the extremities (I70.26)
- gangrene in hernia (K40.1, K40.4, K41.1, K41.4, K42.1, K43.1-, K44.1, K45.1, K46.1)
- gangrene in other peripheral vascular diseases (I73.-)
- gangrene of certain specified sites - see Alphabetical Index
- gas gangrene (A48.0)
- pyoderma gangrenosum (L88)
Excludes2: not included here, code separately if applicable
- gangrene in diabetes mellitus (E08-E13 with .52)
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 I95-I99
Other and unspecified disorders of the circulatory system (I95-I99)
- I95Hypotension
- I96Gangrene, not elsewhere classified(this code)
- I97Intraoperative and postprocedural complications and disorders of circulatory system, not elsewhere classified
- I99Other and unspecified disorders of circulatory system
I96 MS-DRGs
As the principal diagnosis, I96 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.
I96 is in Gangrene (CIR028, its default category), with 55 codes. Others in it:
- E08.52 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
- E09.52 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
- E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
- E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
- E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
- I70.261 Atherosclerosis of native arteries of extremities with gangrene, right leg
- I70.262 Atherosclerosis of native arteries of extremities with gangrene, left leg
- I70.263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legs
Medicare coverage articles listing I96
These 17 Medicare billing and coding articles list I96 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.
- Surgical Treatment of Nails (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)
- Computerized Axial Tomography (CT), Thorax
- Debridement Services
- Electrocardiograms
- Home Health Occupational Therapy
- Home Health Physical Therapy
- Magnetic Resonance Angiography
And 7 more.
Other codes that refer to I96
Notes on these codes point to I96.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Gangrene
Gangrene is the death of tissues in your body. It happens when a part of your body loses its blood supply. Gangrene can happen on the surface of the body, such as on the skin, or inside the body, in muscles or organs. Causes include:
Read more about gangrene on MedlinePlusCode 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).
- 785.4 Gangrene (approximate)