What is ICD-10 code I72.6?

I72.6 is the ICD-10-CM diagnosis code for Aneurysm of vertebral artery. A weakened, bulging section of the vertebral artery in the neck that carries blood to the brain and requires careful monitoring. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I72.6 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I72.6 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I72.6 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I72.6 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does I72.6 map to under V28?

I72.6 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

What does I72.6 pay in RAF?

I72.6 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

What is the V28 vs V24 difference for I72.6?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. I72.6 was a payment HCC under V24 (Vascular Disease) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

2026 ICD-10-CM I72.6: Aneurysm of vertebral artery

I72.6 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupI72.6Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of arteries, arterioles and capillaries (I70-I79)

I72.6

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Aneurysm of vertebral artery

A weakened, bulging section of the vertebral artery in the neck that carries blood to the brain and requires careful monitoring.

Buddy Insight

Vertebral artery aneurysm is a rare but clinically important condition due to the risk of posterior circulation stroke, subarachnoid hemorrhage (if intradural), or brainstem compression.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 108

Vascular Disease

RAF 0.288

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 108

Vascular Disease

RAF 0.073

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I72Other aneurysm

I72.6Aneurysm of vertebral artery

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I72.6 in this effective period.

Excludes 2

Official

dissection of vertebral artery (I77.74)

Related Child Codes

Official

I72.0Aneurysm of carotid artery

I72.1Aneurysm of artery of upper extremity

I72.2Aneurysm of renal artery

I72.3Aneurysm of iliac artery

I72.4Aneurysm of artery of lower extremity

Includes

Official

aneurysm (cirsoid) (false) (ruptured)

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I72.6 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I72.6 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I72.6 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I72.6 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation specifying vertebral artery aneurysm (extracranial segment)

Imaging confirmation (CT angiography, MR angiography, or conventional angiography)

Size and morphology (saccular vs fusiform)

Laterality (right, left, or bilateral)

MEAT Support

HCC Buddy guidance

Documentation specifying vertebral artery aneurysm (extracranial segment)

Imaging confirmation (CT angiography, MR angiography, or conventional angiography)

Size and morphology (saccular vs fusiform)

Laterality (right, left, or bilateral)

Audit Caution

HCC Buddy guidance

Confusing extracranial vertebral artery aneurysm (I72.6) with intracranial vertebral aneurysm (I67.1) — the segment matters

Not recognizing vertebral artery dissection with pseudoaneurysm formation as potentially codeable here

Using the unspecified aneurysm code I72.9 when vertebral artery is clearly documented

Failing to code associated posterior circulation transient ischemic attack or stroke when documented

Common Mistakes

HCC Buddy guidance

I72.5 — Aneurysm of other precerebral arteries: for non-carotid, non-vertebral precerebral vessels

I72.0 — Aneurysm of carotid artery: different precerebral artery

I67.1 — Cerebral aneurysm, nonruptured: intracranial aneurysm including intradural vertebral — check documentation for location

I63.0xx — Cerebral infarction due to thrombosis of precerebral arteries: stroke event, not the aneurysm itself

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is I72.6 an HCC code?

Yes. I72.6 maps to Vascular Disease under the V24 model but is not retained in V28.

Code: I72.6
Description: Aneurysm of vertebral artery
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 108, Vascular Disease

0.288

ESRDHCC 108, Vascular Disease

0.073

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work I72.6 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I72.6

For I72.6 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I72.6 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I72.6 is the ICD-10-CM diagnosis code for aneurysm of vertebral artery. A weakened, bulging section of the vertebral artery in the neck that carries blood to the brain and requires careful monitoring. I72.6 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of arteries, arterioles and capillaries (i70-i79).

Under the older CMS-HCC V24 model, I72.6 maps to Vascular Disease (HCC 108) with a community, non-dual, aged base RAF weight of 0.288. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Specify laterality (right/left) when documented in the medical record. Because I72.6 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I72.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Specify laterality (right/left) when documented in the medical record
•Note whether the aneurysm is ruptured or non-ruptured for accurate code selection

Clinical Significance

Vertebral artery aneurysm is a rare but clinically important condition due to the risk of posterior circulation stroke, subarachnoid hemorrhage (if intradural), or brainstem compression. The vertebral arteries supply the posterior brain, and aneurysms in this territory require specialized neurovascular management. Accurate coding reflects the complexity of this vascular condition.

Documentation Requirements

✓Documentation specifying vertebral artery aneurysm (extracranial segment)
✓Imaging confirmation (CT angiography, MR angiography, or conventional angiography)
✓Size and morphology (saccular vs fusiform)
✓Laterality (right, left, or bilateral)
✓Segment involved (V1-V4 when documented)
✓Assessment of posterior circulation symptoms
✓Treatment plan (observation, endovascular, or surgical)

Excludes 2, Not included here, may code separately

dissection of vertebral artery (I77.74)

Commonly Confused Codes

•I72.5: Aneurysm of other precerebral arteries: for non-carotid, non-vertebral precerebral vessels
•I72.0: Aneurysm of carotid artery: different precerebral artery
•I67.1: Cerebral aneurysm, nonruptured: intracranial aneurysm including intradural vertebral: check documentation for location
•I63.0xx: Cerebral infarction due to thrombosis of precerebral arteries: stroke event, not the aneurysm itself