I74.8
BillableEmbolism and thrombosis of other arteries
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is I74.8 an HCC code?
Yes. I74.8 maps to Vascular Disease with Complications under the CMS-HCC V28 risk adjustment model (and Vascular Disease with Complications under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for I74.8
For I74.8to 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 I74.8 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
I74.8 is the ICD-10-CM diagnosis code for embolism and thrombosis of other arteries. A blood clot in arteries other than the aorta or extremity arteries, such as in the mesenteric, renal, or cerebral arteries. I74.8 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 CMS-HCC V28 risk adjustment model, I74.8 maps to Vascular Disease with Complications (HCC 264) with a community, non-dual, aged base RAF weight of 0.356. Under the older V24 model, I74.8 mapped to the same category but with a base RAF weight of 0.450 — V28 recalibrated weights across the entire model. 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.
Documentation must clearly identify which specific artery is affected to justify this code. Because I74.8 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 I74.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Documentation must clearly identify which specific artery is affected to justify this code
- •Consider whether additional codes for organ-specific ischemia or infarction are needed based on clinical consequences
Clinical Significance
Embolism and thrombosis of other arteries captures acute arterial occlusion in vascular territories not specifically classified elsewhere, such as mesenteric, splenic, hepatic, or other named arteries. Mesenteric artery embolism in particular is a life-threatening condition that can lead to intestinal infarction. This code ensures capture of these serious vascular complications.
Documentation Requirements
- ✓Documentation specifying the affected artery
- ✓Imaging or surgical confirmation of the thromboembolic event
- ✓Clinical presentation and end-organ effects
- ✓Source of embolism evaluation
- ✓Treatment documentation (anticoagulation, thrombectomy, surgical intervention)
- ✓Assessment of organ viability and damage
Commonly Confused Codes
- •I74.2-I74.5 — Specific arterial embolism codes: use the more specific code when the artery has one
- •I74.9 — Embolism and thrombosis of unspecified artery: use I74.8 when the artery is named but not elsewhere classified
- •K55.0xx — Acute vascular disorders of intestine: mesenteric ischemia from arterial embolism may use K55 series
- •I72.8 — Aneurysm of other specified arteries: aneurysm rather than thromboembolism