2027 ICD-10-CM Diagnosis Code I76Septic arterial embolism
ICD-10-CM Codes›I00–I99›I70-I79›I76
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 264
- Not a Principal Diagnosis
- Not Chronic
I76 is a billable ICD-10-CM diagnosis code for septic arterial embolism. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 299 through 301, 791, 793. 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 63 closely related codes. The code is not accepted as a principal diagnosis by the Medicare Code Editor. Coders also document this condition as embolism due to infective heart valve vegetation. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aortic and peripheral arterial embolism or thrombosis and Bacterial infections.
For Medicare Advantage risk adjustment, I76 maps to CMS-HCC Category 264 (Vascular Disease with Complications) under the V28 model, adding a risk factor of about 0.455 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for I76.
Medicare Risk Adjustment (HCC)Billing
I76 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
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.
- Embolism due to infective heart valve vegetation
- Intracranial arterial septic embolism
- Intracranial septic embolism
- Septic embolus of artery
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to I76: its own notes plus those printed at Chapter 9. A note printed at a category, block or chapter applies to every code under it.
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.
- 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.-)
Code First
The underlying condition named in the note is sequenced before this code.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify the site of the embolism (I74.-)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name I76, its category, or a range that includes it.
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.
Convert I76 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About I76Overview
What is the ICD-10 code for septic arterial embolism?
The ICD-10-CM code for septic arterial embolism is I76. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is I76 (Septic arterial embolism) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report septic arterial embolism on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does I76 group to?
On inpatient claims, septic arterial embolism maps to MS-DRG 793, 791, 301, 300, 299, with relative weights from 0.7132 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is I76 a CC or MCC?
CMS lists I76 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 63 closely related codes in its exclusion list.
Can I76 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because septic arterial embolism describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
What HCC is I76?
I76 (septic arterial embolism) maps to CMS-HCC Category 264 (Vascular Disease with Complications), commonly written as HCC 264, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 107 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does I76 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I76 adds a risk adjustment factor of about 0.455 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.338 to 0.622 depending on the payment segment). A more severe related category (HCC 263) supersedes it when both are reported. See the full factor table on the HCC 264 category page.
