What is ICD-10 code I75.011?

I75.011 is the ICD-10-CM diagnosis code for Atheroembolism of right upper extremity. Cholesterol crystals or plaque fragments break loose from arteries and lodge in blood vessels of the right arm, restricting blood flow to that limb. I75.011 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I75.011 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. I75.011 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. I75.011 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 I75.011 map to under V28?

I75.011 maps to CMS-HCC V28 264 (Vascular Disease with Complications). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does I75.011 pay in RAF?

I75.011 carries a community, non-dual, aged (CNA) RAF weight of 0.455 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for I75.011?

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. For I75.011, V28 maps to Vascular Disease with Complications at RAF 0.455 while V24 mapped to Vascular Disease with Complications at RAF 0.383. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports I75.011?

Verify documentation specifies right upper extremity to distinguish from bilateral or left-sided involvement Look for associated atherosclerotic disease documentation to support medical necessity Because I75.011 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. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM I75.011: Atheroembolism of right

I75.011 maps to CMS-HCC V28 264 (RAF 0.455). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

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

Code lookupI75.011Effective 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)

I75.011

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

Atheroembolism of right upper extremity

Cholesterol crystals or plaque fragments break loose from arteries and lodge in blood vessels of the right arm, restricting blood flow to that limb.

Buddy Insight

CMS-HCC V28

Mapped

HCC 264

Vascular Disease with Complic...

RAF 0.455

CMS-HCC V24

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.383

ACA/HHS

Mapped

HCC 154

HHS-HCC 154

Varies by metal level

ESRD/PACE

Mapped

HCC 107

Vascular Disease with Complic...

RAF 0.144

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I75.0Atheroembolism of extremities

I75.01Atheroembolism of upper extremity

I75.011Atheroembolism of right upper extremity

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I75.011 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I75.011 in this effective period.

Related Child Codes

Official

I75.012Atheroembolism of left upper extremity

I75.013Atheroembolism of bilateral upper extremities

I75.019Atheroembolism of unspecified upper extremity

Includes

Official

ICD-10-CM does not list Includes notes for I75.011 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I75.011 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I75.011 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I75.011 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I75.011 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of atheroembolism (cholesterol embolism) affecting the right upper extremity

Clinical findings (blue finger syndrome, livedo reticularis, digital ischemia, gangrene)

Identification of the embolic source when possible (aortic atherosclerotic disease)

Precipitating event if identified (vascular procedure, anticoagulation initiation)

MEAT Support

HCC Buddy guidance

Documentation of atheroembolism (cholesterol embolism) affecting the right upper extremity

Clinical findings (blue finger syndrome, livedo reticularis, digital ischemia, gangrene)

Identification of the embolic source when possible (aortic atherosclerotic disease)

Precipitating event if identified (vascular procedure, anticoagulation initiation)

Audit Caution

HCC Buddy guidance

Coding as generic arterial embolism (I74.2) when documentation specifically describes atheroembolism or cholesterol embolism

Not documenting laterality and defaulting to unspecified upper extremity

Missing the diagnosis when presentation is described as 'blue finger syndrome' or 'trash foot/hand' without using the term atheroembolism

Failing to code the underlying source of atherosclerotic disease as an additional diagnosis

Common Mistakes

HCC Buddy guidance

I75.012 — Atheroembolism of left upper extremity: opposite laterality

I75.019 — Atheroembolism of unspecified upper extremity: use right-specific code when laterality is documented

I74.2 — Embolism and thrombosis of arteries of the upper extremities: general thromboembolism rather than specifically atheroembolism

I75.021 — Atheroembolism of right lower extremity: different extremity

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 I75.011 an HCC code?

Yes. I75.011 (Atheroembolism of right upper extremity) maps to Vascular Disease with Complications under the CMS-HCC V28 risk adjustment model (and Vascular Disease with Complications under V24), with a community non-dual aged RAF of 0.455. It is billable for payment year 2026.

Coder answer: I75.011 is billable and maps to V28 HCC 264, Vascular Disease with Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: I75.011
Description: Atheroembolism of right upper extremity
HCC (V28): HCC 264 — Vascular Disease with Complications
RAF: 0.455
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 264, Vascular Disease with Complications

0.455

V24HCC 107, Vascular Disease with Complications

0.383

ESRDHCC 107, Vascular Disease with Complications

0.144

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 I75.011 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I75.011

For I75.011 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 I75.011 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

I75.011 is the ICD-10-CM diagnosis code for atheroembolism of right upper extremity. Cholesterol crystals or plaque fragments break loose from arteries and lodge in blood vessels of the right arm, restricting blood flow to that limb. I75.011 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, I75.011 maps to Vascular Disease with Complications (HCC 264) with a community, non-dual, aged base RAF weight of 0.455. Under the older V24 model, I75.011 mapped to the same category but with a base RAF weight of 0.383, 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.

Verify documentation specifies right upper extremity to distinguish from bilateral or left-sided involvement. Because I75.011 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 I75.011 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation specifies right upper extremity to distinguish from bilateral or left-sided involvement
•Look for associated atherosclerotic disease documentation to support medical necessity

Clinical Significance

Atheroembolism of the right upper extremity occurs when cholesterol crystals and atherosclerotic debris embolize from a proximal source (typically the aorta) to the digital arteries of the right arm or hand. This can cause blue toe/finger syndrome, livedo reticularis, or digital gangrene. It is a marker of severe proximal atherosclerotic disease and carries significant morbidity.

Documentation Requirements

✓Documentation of atheroembolism (cholesterol embolism) affecting the right upper extremity
✓Clinical findings (blue finger syndrome, livedo reticularis, digital ischemia, gangrene)
✓Identification of the embolic source when possible (aortic atherosclerotic disease)
✓Precipitating event if identified (vascular procedure, anticoagulation initiation)
✓Laboratory findings (eosinophilia, elevated creatinine, elevated erythrocyte sedimentation rate)
✓Treatment plan and tissue viability assessment

Commonly Confused Codes

•I75.012: Atheroembolism of left upper extremity: opposite laterality
•I75.019: Atheroembolism of unspecified upper extremity: use right-specific code when laterality is documented
•I74.2: Embolism and thrombosis of arteries of the upper extremities: general thromboembolism rather than specifically atheroembolism
•I75.021: Atheroembolism of right lower extremity: different extremity