2026 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 2026 (October 1, 2025 through September 30, 2026) 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 Septicemia.
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 2026.
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 2026.
Source: CMS Payment Year 2026 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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Code First
Use Additional Code
- code to identify the site of the embolism I74
Type 2 Excludes
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
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, 2025 through September 30, 2026.
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, 2025 through September 30, 2026.
What MS-DRG does I76 group to?
On inpatient claims, septic arterial embolism maps to MS-DRG 299, 300, 301, 791, 793, with relative weights from 0.7197 to 4.1696 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 2026. 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 2026. 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.
