2027 ICD-10-CM Diagnosis Code N49.3Fournier gangrene
ICD-10-CM Codes›N00–N99›N40-N53›N49
- Billable — Valid for Submission
- Risk Adjusts — HCC 92
- Not Chronic
N49.3 is a billable ICD-10-CM diagnosis code for fournier gangrene. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 727 through 728. Coders also document this condition as gangrene of perineum. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Gangrene and Inflammatory conditions of male genital organs.
For Medicare Advantage risk adjustment, N49.3 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
N49.3 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
- Inflammation of scrotum
- Necrotizing fasciitis of penis
- Necrotizing fasciitis of perineal and/or genital and/or perianal region
- Necrotizing fasciitis of scrotum
- Penile gangrene
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to N49.3: its own notes plus those printed at N49 and Chapter 14. 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.
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)
Use Additional Code
Add a second code, after this one, to fully describe the 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 N49.3, its category, or a range that includes it.
Excludes2 5
These codes carry an Excludes2 note naming N49.3: its condition is not part of those codes, and both may be reported when the patient has both.
- L02 Cutaneous abscess, furuncle and carbuncleabscess of male genital organs (external) (N48.2, N49.-) names N49.-, which includes this code
- L02.2 Cutaneous abscess, furuncle and carbuncle of trunkabscess of male external genital organs (N48.2, N49.-) names N49.-, which includes this code
- L03 Cellulitis and acute lymphangitiscellulitis of male external genital organs (N48.2, N49.-) names N49.-, which includes this code
- L03.31 Cellulitis of trunkcellulitis of male external genital organs (N48.2, N49.-) names N49.-, which includes this code
- Block R10-R19 Symptoms and signs involving the digestive system and abdomen
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
Fournier (gangrene) N49.3
Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer) See Also: Necrosis; I96
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Fournier Gangrene
an acute necrotic infection of the scrotum; penis; or perineum. it is characterized by scrotum pain and redness with rapid progression to gangrene and sloughing of tissue. fournier gangrene is usually secondary to perirectal or periurethral infections associated with local trauma, operative procedures, or urinary tract disease.
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 N49.3 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About N49.3Overview
What is the ICD-10 code for fournier gangrene?
The ICD-10-CM code for fournier gangrene is N49.3 (sometimes written as N493). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is N49.3 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report fournier gangrene on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does N49.3 group to?
When fournier gangrene is the principal diagnosis on an inpatient stay, it groups to MS-DRG 727, 728, with relative weights from 0.8220 to 1.3694 depending on complications. Higher weights mean higher Medicare reimbursement.
Can N49.3 be reported with N48.1?
Not as a rule. The Excludes1 note at N49, which applies to N49.3, lists "inflammation of penis (N48.1, N48.2-)". 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 N49.3 need an additional code?
When the condition applies, yes. The Use Additional Code note at N49, which applies to N49.3, reads: code (B95-B97), to identify infectious agent. The additional code is reported after N49.3.
What HCC is N49.3?
N49.3 (fournier gangrene) 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 does not map to any RxHCC in the Part D prescription drug model.
Does N49.3 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, N49.3 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.
