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I73.81 ICD-10-CM Code: Erythromelalgia

I73.81 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

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

I73.81

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

Erythromelalgia

Erythromelalgia is a rare condition characterized by episodes of burning pain, redness, and warmth in the extremities, typically affecting the feet and hands. The symptoms are often triggered by heat, exercise, or stress and can be severely disabling.

Buddy the Bee presenting code insight

Buddy Insight

Erythromelalgia is a rare condition characterized by episodic burning pain, warmth, and redness in the extremities, typically triggered by heat or exercise.

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

HCC 108

RAF 0.288

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

HCC 108

RAF 0.073

RXHCC

N/A

—

Not mapped

Code Book Path

Official
I73Other peripheral vascular diseases
I73.8Other specified peripheral vascular diseases
I73.81Erythromelalgia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I73.81 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I73.81 in this effective period.

Related Child Codes

Official
I73.89Other specified peripheral vascular diseases

Includes

Official

ICD-10-CM does not list Includes notes for I73.81 in this effective period.

Excludes 1

Official
  • diabetic (peripheral) angiopathy (E08-E13 with .51-.52)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I73.81 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I73.81 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I73.81 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of erythromelalgia diagnosis with symptom description
Affected extremities and distribution
Primary vs secondary classification
Underlying condition if secondary (myeloproliferative disorder, connective tissue disease)

MEAT Support

HCC Buddy guidance
Documentation of erythromelalgia diagnosis with symptom description
Affected extremities and distribution
Primary vs secondary classification
Underlying condition if secondary (myeloproliferative disorder, connective tissue disease)

Audit Caution

HCC Buddy guidance
Coding as unspecified peripheral vascular disease when the provider documents erythromelalgia specifically
Not coding the underlying myeloproliferative disorder when erythromelalgia is secondary
Confusing erythromelalgia with erythema (skin redness) — erythromelalgia is a specific vascular diagnosis
Missing this diagnosis when it appears in the medication list (aspirin for erythromelalgia) but not in the problem list

Common Mistakes

HCC Buddy guidance
I73.89 — Other specified peripheral vascular diseases: for other peripheral vascular conditions not specifically classified
I73.9 — Peripheral vascular disease, unspecified: less specific code that should not be used when erythromelalgia is documented
I73.00 — Raynaud's syndrome without gangrene: opposite clinical presentation (cold-induced pallor vs heat-induced redness)
L53.9 — Erythematous condition, unspecified: skin condition, not vascular

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 I73.81 an HCC code?

Yes. I73.81 maps to Vascular Disease under the V24 model but is not retained in V28.

Code
I73.81
Description
Erythromelalgia
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 I73.81 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I73.81

For I73.81 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 I73.81 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I73.81 is the ICD-10-CM diagnosis code for erythromelalgia. Erythromelalgia is a rare condition characterized by episodes of burning pain, redness, and warmth in the extremities, typically affecting the feet and hands. The symptoms are often triggered by heat, exercise, or stress and can be severely disabling. I73.81 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, I73.81 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.

Verify whether this is primary erythromelalgia (I73.81) or secondary to another condition like myeloproliferative disorder, as secondary cases may require additional coding. Because I73.81 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 I73.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify whether this is primary erythromelalgia (I73.81) or secondary to another condition like myeloproliferative disorder, as secondary cases may require additional coding
  • •Document the affected sites (bilateral feet, hands, etc.) and severity of symptoms to support medical necessity for treatment and management

Clinical Significance

Erythromelalgia is a rare condition characterized by episodic burning pain, warmth, and redness in the extremities, typically triggered by heat or exercise. It can be primary (idiopathic/genetic) or secondary to myeloproliferative disorders or other conditions. While not life-threatening, it significantly impacts quality of life and reflects underlying vascular dysfunction requiring ongoing management.

Documentation Requirements

  • ✓Documentation of erythromelalgia diagnosis with symptom description
  • ✓Affected extremities and distribution
  • ✓Primary vs secondary classification
  • ✓Underlying condition if secondary (myeloproliferative disorder, connective tissue disease)
  • ✓Triggering factors and symptom severity
  • ✓Treatment plan (aspirin, cooling measures, sodium channel blockers, or other medications)

Commonly Confused Codes

  • •I73.89: Other specified peripheral vascular diseases: for other peripheral vascular conditions not specifically classified
  • •I73.9: Peripheral vascular disease, unspecified: less specific code that should not be used when erythromelalgia is documented
  • •I73.00: Raynaud's syndrome without gangrene: opposite clinical presentation (cold-induced pallor vs heat-induced redness)
  • •L53.9: Erythematous condition, unspecified: skin condition, not vascular

Child Codes

I73.81Erythromelalgia
I73.89Other specified peripheral vascular diseases

Code Hierarchy

└I73Other peripheral vascular diseases└I73.8Other specified peripheral vascular diseases└I73.81Erythromelalgia
└I73.81Erythromelalgia

Because I73.81 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

More on I73.81

Related condition guides

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