2027 ICD-10-CM Diagnosis Code I67.4Hypertensive encephalopathy

ICD-10-CM Codes›I00–I99›I60-I69›I67

ICD-10-CM I67.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

I67.4 is a billable ICD-10-CM diagnosis code for hypertensive encephalopathy. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 70 through 72. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 62 closely related codes. Coders also document this condition as dementia due to hypertensive encephalopathy. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hypertension with complications and secondary hypertension and Other nervous system disorders (neither hereditary nor degenerative).

I67.4 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 187 for payment year 2027.

Code Identity

ICD-10-CM Code
I67.4
Billable Status
Yes — Valid for Submission
Code Describes
Hypertensive encephalopathy
Short Description
Hypertensive encephalopathy
Same as the full description in the CMS dataset.
Parent Code
I67
Other cerebrovascular diseases

Code Classification

ChapterI00–I99Diseases of the circulatory system
SectionI60-I69Cerebrovascular diseases
CategoryI67Other cerebrovascular diseases
This CodeI67.4Hypertensive encephalopathy

Medicare Risk Adjustment (HCC)Billing

I67.4 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 187 — Hypertension
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Dementia due to hypertensive encephalopathy
  • Dementia due to metabolic abnormality
  • Hypertensive encephalopathy

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to I67.4: its own notes plus those printed at I67, block I60-I69, and Chapter 9. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From I67 Other cerebrovascular diseases applies to 17 codes
  • Occlusion and stenosis of cerebral artery causing cerebral infarction (I63.3-I63.5-)
  • Occlusion and stenosis of precerebral artery causing cerebral infarction (I63.2-)
From Block I60-I69 Cerebrovascular diseases applies to 410 codes
  • traumatic intracranial hemorrhage (S06.-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On I67.4 itself
  • insufficiency, NOS, of precerebral arteries (G45.2)
From I67 Other cerebrovascular diseases applies to 17 codes
  • sequelae of the listed conditions (I69.8)
From Chapter 9 (I00-I99) Diseases of the circulatory system applies to 1,433 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Block I60-I69 Cerebrovascular diseases applies to 410 codes
  • code to identify presence of:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • hypertension (I10-I1A)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

  • if applicable, associated hypertensive conditions such as:
  • essential (primary) hypertension (I10)
  • hypertensive chronic kidney disease (I12.-)
  • hypertensive heart and chronic kidney disease (I13.-)
  • hypertensive heart disease (I11.-)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name I67.4, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming I67.4: they are not reported together with it, unless the two conditions are unrelated.

  • G93.2 Benign intracranial hypertension
    hypertensive encephalopathy (I67.4)

Excludes2 1

These codes carry an Excludes2 note naming I67.4: its condition is not part of those codes, and both may be reported when the patient has both.

  • G93.4 Other and unspecified encephalopathy
    hypertensive encephalopathy (I67.4)

Code Also 1

These codes say I67.4 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • I16.1 Hypertensive emergency
    hypertensive encephalopathy (I67.4)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR CIR008
Hypertension with complications and secondary hypertension
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR NVS020
Other nervous system disorders (neither hereditary nor degenerative)
Default principal diagnosis: inpatient No · outpatient No

Clinical InformationClinical

  • Hypertensive Encephalopathy

    brain dysfunction or damage resulting from sustained malignant hypertension. when blood pressure exceeds the limits of cerebral autoregulation, cerebral blood flow is impaired (brain ischemia). clinical manifestations include headache; nausea; vomiting; seizures; altered mental status (in some cases progressing to coma); papilledema; and retinal hemorrhage.

Patient EducationClinical

Brain Diseases

Your brain is the control center of your body. It controls your thoughts, memory, speech, and movement. It regulates the function of many organs. It's part of your nervous system, which also includes your spinal cord and peripheral nerves. The nervous system sends signals between your brain and the rest of the body.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert I67.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
437.2 Hypertens encephalopathy
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About I67.4Overview

What is the ICD-10 code for hypertensive encephalopathy?

The ICD-10-CM code for hypertensive encephalopathy is I67.4 (sometimes written as I674). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is I67.4 (Other cerebrovascular diseases) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report hypertensive encephalopathy on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does I67.4 group to?

When hypertensive encephalopathy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 72, 70, 71, with relative weights from 0.7344 to 1.6089 depending on complications. Higher weights mean higher Medicare reimbursement.

Is I67.4 a CC or MCC?

CMS lists I67.4 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 62 closely related codes in its exclusion list.

Can I67.4 be reported with a code from I63.2?

Not as a rule. The Excludes1 note at I67, which applies to I67.4, lists "Occlusion and stenosis of precerebral artery causing cerebral infarction (I63.2-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does I67.4 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: I67.4 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 187 (Hypertension).