2026 ICD-10-CM Diagnosis Code I96Gangrene, not elsewhere classified
ICD-10-CM Codes›I00–I99›I95-I99›I96
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 263
- Not Chronic
I96 is a billable ICD-10-CM diagnosis code for gangrene, not elsewhere classified. 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 45 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gangrene.
For Medicare Advantage risk adjustment, I96 maps to CMS-HCC Category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) under the V28 model, adding a risk factor of about 1.118 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
I96 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.
- Acral gangrene
- Application site necrosis
- Bilateral gangrene of feet
- Bilateral gangrene of finger
- Bilateral gangrene of toe
- Colostomy necrosis
- Coumarin necrosis
- Dermatosis caused by coumarin
- Disorder of skin due to radiotherapy
- Ergotism
- Flap necrosis
- Gangrene due to arterial insufficiency
- Gangrene due to peripheral vascular disease
- Gangrene of buttock
- Gangrene of colostomy
- Gangrene of finger
- Gangrene of finger of left hand
- Gangrene of finger of right hand
- Gangrene of foot
- Gangrene of hand
- Gangrene of left foot
- Gangrene of newborn
- Gangrene of perineum
- Gangrene of right foot
- Gangrene of thumb
- Gangrene of toe
- Gangrene of toe of left foot
- Gangrene of toe of right foot
- Gangrenous disorder
- Gangrenous ergotism
- Gangrenous pressure injury
- Gastrointestinal anastomotic necrosis
- Ileostomy necrosis
- Injection site necrosis
- Ischemic gangrene
- Necrosis caused by ionizing radiation
- Necrosis following injection of local anesthetic
- Necrosis of myocutaneous flap
- Necrosis of skin due to and following injection of filler
- Necrosis of skin flap
- Necrosis of stoma
- Necrosis of subcutaneous tissue
- Non-healing surgical wound
- Partial myocutaneous flap necrosis
- Peripheral gangrene
- Progressive cutaneous gangrene
- Radionecrosis of skin
- Radionecrosis of skin due to and following radiotherapy
- Skin necrosis
- Skin necrosis due to heparin induced thrombocytopenia
- Surgical wound necrosis
- Tissue necrosis
- Total necrosis of myocutaneous flap
- Wound edge finding
- Wound edge necrosis
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Gangrenous cellulitis
Type 1 Excludes
- 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
Type 2 Excludes
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
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.
Acrosphacelus I96
Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer) See Also: Necrosis; I96
abdomen (wall) I96
auricle I96
perineum I96
spine I96
umbilicus I96
Necrosis, necrotic (ischemic) See Also: Gangrene;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Ergotism
poisoning caused by ingesting ergotized grain or by the misdirected or excessive use of ergot as a medicine.
Patient EducationClinical
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 the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert I96 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About I96Overview
What is the ICD-10 code for gangrene, not elsewhere classified?
The ICD-10-CM code for gangrene, not elsewhere classified is I96. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is I96 (Gangrene, not elsewhere classified) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report gangrene, not elsewhere classified on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does I96 group to?
When gangrene, not elsewhere classified is the principal diagnosis on an inpatient stay, it groups 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 I96 a CC or MCC?
CMS lists I96 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 45 closely related codes in its exclusion list.
What is the ICD-9 equivalent of I96?
Under the General Equivalence Mappings, gangrene, not elsewhere classified converts to ICD-9-CM 785.4 (gangrene). The mapping is approximate, so confirm the match fits the documentation.
What HCC is I96?
I96 (gangrene, not elsewhere classified) maps to CMS-HCC Category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene), commonly written as HCC 263, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 106 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 I96 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, I96 adds a risk adjustment factor of about 1.118 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.696 to 1.432 depending on the payment segment). HCC 263 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 263 category page.
