What is ICD-10 code I75.81?

I75.81 is the ICD-10-CM diagnosis code for Atheroembolism of kidney. Cholesterol crystals or plaque fragments break loose from arteries and lodge in the blood vessels of the kidney, potentially affecting kidney function. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I75.81 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I75.81 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. I75.81 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. I75.81 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 I75.81 map to under V28?

I75.81 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 I75.81 pay in RAF?

I75.81 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 I75.81?

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 I75.81, 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.

2026 ICD-10-CM I75.81: Atheroembolism

I75.81 maps to CMS-HCC V28 264 (RAF 0.455). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupI75.81Effective 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)

I75.81

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

Atheroembolism of kidney

Cholesterol crystals or plaque fragments break loose from arteries and lodge in the blood vessels of the kidney, potentially affecting kidney function.

Buddy Insight

Atheroembolism of the kidney (renal cholesterol embolism) is a serious complication that can cause progressive renal failure, often mimicking other causes of acute kidney injury.

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

I75Atheroembolism

I75.8Atheroembolism of other sites

I75.81Atheroembolism of kidney

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I75.81 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I75.81 in this effective period.

Related Child Codes

Official

I75.89Atheroembolism of other site

Includes

Official

ICD-10-CM does not list Includes notes for I75.81 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I75.81 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I75.81 in this effective period.

Use Additional

Official

code for any associated acute kidney failure and chronic kidney disease (N17.-, N18.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for I75.81 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of renal atheroembolism or cholesterol embolism to the kidney

Renal function parameters (creatinine, glomerular filtration rate) before and after the event

Precipitating event (aortic procedure, catheterization, anticoagulation)

Supportive laboratory findings (eosinophilia, elevated erythrocyte sedimentation rate, low complement)

MEAT Support

HCC Buddy guidance

Documentation of renal atheroembolism or cholesterol embolism to the kidney

Renal function parameters (creatinine, glomerular filtration rate) before and after the event

Precipitating event (aortic procedure, catheterization, anticoagulation)

Supportive laboratory findings (eosinophilia, elevated erythrocyte sedimentation rate, low complement)

Audit Caution

HCC Buddy guidance

Coding only the acute kidney injury without identifying the atheroembolism as the underlying cause

Missing this diagnosis when renal function declines after a vascular procedure — consider atheroembolism in the differential

Not separately coding the resultant renal failure when present in addition to the atheroembolism

Confusing renal atheroembolism with renal artery thromboembolism — different pathophysiology

Common Mistakes

HCC Buddy guidance

I75.89 — Atheroembolism of other site: for non-renal, non-extremity atheroembolism

N17.x — Acute kidney failure: may coexist but does not capture the atheroembolism etiology

I75.021-I75.029 — Atheroembolism of lower extremity: different target organ

N28.0 — Ischemia and infarction of kidney: different etiology than cholesterol embolism

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 I75.81 an HCC code?

Yes. I75.81 (Atheroembolism of kidney) 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: I75.81 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: I75.81
Description: Atheroembolism of kidney
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 I75.81 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I75.81

For I75.81 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 I75.81 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I75.81 is the ICD-10-CM diagnosis code for atheroembolism of kidney. Cholesterol crystals or plaque fragments break loose from arteries and lodge in the blood vessels of the kidney, potentially affecting kidney function. I75.81 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 CMS-HCC V28 risk adjustment model, I75.81 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, I75.81 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.

Document any associated acute kidney injury or renal function changes. Because I75.81 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 I75.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document any associated acute kidney injury or renal function changes
•May be discovered incidentally during imaging or when renal function declines

Clinical Significance

Atheroembolism of the kidney (renal cholesterol embolism) is a serious complication that can cause progressive renal failure, often mimicking other causes of acute kidney injury. It typically occurs after vascular procedures or anticoagulation initiation and may be underdiagnosed. This condition indicates severe systemic atherosclerotic disease and carries significant implications for renal function and overall prognosis.

Documentation Requirements

✓Documentation of renal atheroembolism or cholesterol embolism to the kidney
✓Renal function parameters (creatinine, glomerular filtration rate) before and after the event
✓Precipitating event (aortic procedure, catheterization, anticoagulation)
✓Supportive laboratory findings (eosinophilia, elevated erythrocyte sedimentation rate, low complement)
✓Biopsy findings if performed (cholesterol clefts in renal vasculature)
✓Renal replacement therapy requirements if applicable

Use Additional Code

code for any associated acute kidney failure and chronic kidney disease (N17.-, N18.-)

Commonly Confused Codes

•I75.89: Atheroembolism of other site: for non-renal, non-extremity atheroembolism
•N17.x: Acute kidney failure: may coexist but does not capture the atheroembolism etiology
•I75.021-I75.029: Atheroembolism of lower extremity: different target organ
•N28.0: Ischemia and infarction of kidney: different etiology than cholesterol embolism