2027 ICD-10-CM Diagnosis Code M72.6Necrotizing fasciitis
ICD-10-CM Codes›M00–M99›M70-M79›M72
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 92
- Not Chronic
M72.6 is a billable ICD-10-CM diagnosis code for necrotizing fasciitis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 557 through 558. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 226 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified connective tissue disease.
For Medicare Advantage risk adjustment, M72.6 maps to CMS-HCC Category 92 (Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis) under the V28 model, adding a risk factor of about 0.479 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
M72.6 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.
- Gangrene of perineum
- Gangrene of scrotum
- Infantile streptococcal infection
- Inflammation of scrotum
- Injury of fascia of pelvis
- Mixed infectious disease
- Necrotizing fasciitis
- Necrotizing fasciitis caused by Streptococcus pyogenes
- Necrotizing fasciitis of foot
- Necrotizing fasciitis of left foot
- Necrotizing fasciitis of perineal and/or genital and/or perianal region
- Necrotizing fasciitis of right foot
- Necrotizing fasciitis of scrotum
- Necrotizing fasciitis of scrotum and perineum
- Neonatal necrotizing fasciitis
- Neonatal necrotizing fasciitis caused by Streptococcus
- Neonatal staphylococcal necrotizing fasciitis
- Neonatal streptococcal infection
- Polymicrobial necrotizing fasciitis
- Streptococcus pyogenes infection
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M72.6: its own notes plus those printed at M72 and Chapter 13. 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.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- 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)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M72.6, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
necrotizing M72.6
necrotizing M72.6
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Fasciitis, Necrotizing
a fulminating bacterial infection of the deep layers of the skin and fascia. it can be caused by many different organisms, with streptococcus pyogenes being the most common.
Patient EducationClinical
Bacterial Infections
Bacteria are tiny organisms (living things) that have only one cell. Under a microscope, they look like balls, rods, or spirals. They can be found almost everywhere on Earth. There are lots of bacteria in and on your body. In fact, your body has about 10 times more bacteria cells than human cells.
The full article covers:
- What are bacteria?
- How do bacterial infections spread?
- What are the treatments for bacterial infections?
- Can bacterial infections be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M72.6 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M72.6Overview
What is the ICD-10 code for necrotizing fasciitis?
The ICD-10-CM code for necrotizing fasciitis is M72.6 (sometimes written as M726). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is M72.6 (Fibroblastic disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report necrotizing fasciitis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does M72.6 group to?
When necrotizing fasciitis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 557, 558, with relative weights from 0.8873 to 1.4883 depending on complications. Higher weights mean higher Medicare reimbursement.
Is M72.6 a CC or MCC?
CMS lists M72.6 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 226 closely related codes in its exclusion list.
Does M72.6 need an additional code?
When the condition applies, yes. The Use Additional Code note reads: code (B95.-, B96.-) to identify causative organism. The additional code is reported after M72.6.
What HCC is M72.6?
M72.6 (necrotizing fasciitis) maps to CMS-HCC Category 92 (Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis), commonly written as HCC 92, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 39 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 M72.6 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, M72.6 adds a risk adjustment factor of about 0.479 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.471 to 0.632 depending on the payment segment). HCC 92 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 92 category page.
