What is ICD-10 code I76?

I76 is the ICD-10-CM diagnosis code for Septic arterial embolism. A blood clot containing bacteria or infected material breaks loose and travels through arteries, potentially causing infection and tissue damage at the site where it lodges. I76 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I76 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. I76 is a payment HCC under the CMS risk adjustment model. Under the CMS-HCC V28 risk adjustment model it maps to Vascular Disease with Complications with a community, non-dual, aged base RAF weight of 0.455. Under the older CMS-HCC V24 model it maps to Vascular Disease with Complications at RAF 0.383. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. HCC Buddy maintains the V28 and V24 mapping, RAF weight, and MEAT documentation criteria for I76 sourced directly from the CMS-HCC model files.

Yes. I76 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. I76 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.

What is the V28 vs V24 difference for I76?

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 I76, 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 should coders know when reporting I76?

Always investigate and document the source of infection and causative organism Coordinate coding with infectious disease documentation and any associated sepsis codes Because I76 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.

I76: Septic arterial embolism — ICD-10 | Vascular Disease with Complications

ICD-10-CM Code View

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Code lookupI76Effective 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)

I76

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

Septic arterial embolism

A blood clot containing bacteria or infected material breaks loose and travels through arteries, potentially causing infection and tissue damage at the site where it lodges.

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

I7Diseases of arteries, arterioles and capillaries (I70-I79)

I76Septic arterial embolism

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I76 in this effective period.

Excludes 2

Official

septic pulmonary embolism (I26.01, I26.90)

Related Child Codes

Official

ICD-10-CM does not list child codes under I76 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for I76 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I76 in this effective period.

Code First

Official

underlying infection, such as:
infective endocarditis (I33.0)
lung abscess (J85.-)

Use Additional

Official

code to identify the site of the embolism (I74.-)

Code Also

Official

ICD-10-CM does not list Code Also instructions for I76 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of septic (infected) arterial embolism

Source of infection (infective endocarditis, infected vascular graft, other intravascular infection)

Affected artery and target organ

Microbiological data (blood cultures, tissue cultures)

MEAT Support

HCC Buddy guidance

Documentation of septic (infected) arterial embolism

Source of infection (infective endocarditis, infected vascular graft, other intravascular infection)

Affected artery and target organ

Microbiological data (blood cultures, tissue cultures)

Audit Caution

HCC Buddy guidance

Coding as non-septic arterial embolism when the infectious nature is documented

Not coding the underlying source of infection (endocarditis, device infection) as an additional diagnosis

Failing to separately code the specific organ affected by the septic embolism

Missing septic emboli to the brain (stroke), spleen (splenic infarct), or kidneys (renal infarct) when multiple organs are involved

Common Mistakes

HCC Buddy guidance

I74.x — Arterial embolism and thrombosis: non-septic arterial embolism without infectious component

I33.0 — Acute and subacute infective endocarditis: the source of septic emboli, not the embolism itself

A41.x — Other sepsis: systemic infection without specific arterial embolism

I72.x — Aneurysm of artery: mycotic aneurysm from septic embolism requires separate coding

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is I76 an HCC code?

Yes. I76 maps to Vascular Disease with Complications under the CMS-HCC V28 risk adjustment model (and Vascular Disease with Complications under V24).

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 I76 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I76

For I76to 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 I76 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I76 is the ICD-10-CM diagnosis code for septic arterial embolism. A blood clot containing bacteria or infected material breaks loose and travels through arteries, potentially causing infection and tissue damage at the site where it lodges. I76 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, I76 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, I76 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.

Always investigate and document the source of infection and causative organism. Because I76 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 I76 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Always investigate and document the source of infection and causative organism
•Coordinate coding with infectious disease documentation and any associated sepsis codes

Clinical Significance

Septic arterial embolism occurs when infected material (typically from infective endocarditis or a vascular graft infection) lodges in an artery, causing both vascular occlusion and infection at the embolic site. This dual pathology creates severe complications including mycotic aneurysm formation, abscess development, and end-organ damage. This code captures a life-threatening complication requiring aggressive treatment.

Documentation Requirements

✓Documentation of septic (infected) arterial embolism
✓Source of infection (infective endocarditis, infected vascular graft, other intravascular infection)
✓Affected artery and target organ
✓Microbiological data (blood cultures, tissue cultures)
✓Imaging findings confirming embolic events
✓Treatment plan (antibiotics, surgical intervention, source control)

Excludes 2, Not included here, may code separately

septic pulmonary embolism (I26.01, I26.90)

Use Additional Code

code to identify the site of the embolism (I74.-)

Code First

underlying infection, such as:
infective endocarditis (I33.0)
lung abscess (J85.-)

Commonly Confused Codes

•I74.x: Arterial embolism and thrombosis: non-septic arterial embolism without infectious component
•I33.0: Acute and subacute infective endocarditis: the source of septic emboli, not the embolism itself
•A41.x: Other sepsis: systemic infection without specific arterial embolism
•I72.x: Aneurysm of artery: mycotic aneurysm from septic embolism requires separate coding

Code Hierarchy

└I76Septic arterial embolism

I76 ICD-10-CM Code: Septic arterial embolism

HCC Buddy Code Card

I76

Is I76 an HCC code?

HCC Category Mapping

MEAT Criteria for I76

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Excludes 2, Not included here, may code separately

Use Additional Code

Code First

Commonly Confused Codes

Code Hierarchy

Work I76 in HCC Buddy