I87.321 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupI87.321

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)

I87.321

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

Chronic venous hypertension (idiopathic) with inflammation of right lower extremity

A chronic condition where high pressure in the veins of the right leg causes swelling and redness without an identifiable underlying cause.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I87.3Chronic venous hypertension (idiopathic)I87.32Chronic venous hypertension (idiopathic) with inflammation I87.321Chronic venous hypertension (idiopathic) with inflammation of right lower extremity

Inclusion Terms

Official

Stasis edemaInherited from I87.3

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from I00-I99
certain infectious and parasitic diseases (A00-B99)Inherited from I00-I99
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from I00-I99
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from I00-I99
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from I00-I99
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from I00-I99
neoplasms (C00-D49)Inherited from I00-I99
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from I00-I99
systemic connective tissue disorders (M30-M36)Inherited from I00-I99
transient cerebral ischemic attacks and related syndromes (G45.-)Inherited from I00-I99

Related Codes

Official

I87.322Chronic venous hypertension (idiopathic) with inflammation of left lower extremity I87.323Chronic venous hypertension (idiopathic) with inflammation of bilateral lower extremity I87.329Chronic venous hypertension (idiopathic) with inflammation of unspecified lower extremity

Includes

Official

No Includes notes are included in this display for I87.321. Check the code and parent instructions in the Code Book.

Excludes 1

Official

chronic venous hypertension due to deep vein thrombosis (I87.0-)Inherited from I87.3
varicose veins of lower extremities (I83.-)Inherited from I87.3

Code First

Official

No Code First sequencing instructions are included in this display for I87.321. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for I87.321. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for I87.321. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Distinguish between inflammation alone (this code) and inflammation with ulcer (I87.331)

Document the type and extent of inflammation to support medical necessity

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 I87.321 an HCC code?

No. I87.321 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: I87.321
Description: Chronic venous hypertension (idiopathic) with inflammation of right lower extremity
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

I87.321 is the ICD-10-CM diagnosis code for chronic venous hypertension (idiopathic) with inflammation of right lower extremity. A chronic condition where high pressure in the veins of the right leg causes swelling and redness without an identifiable underlying cause. I87.321 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (i80-i89).

I87.321 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Distinguish between inflammation alone (this code) and inflammation with ulcer (I87.331).

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for I87.321 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Distinguish between inflammation alone (this code) and inflammation with ulcer (I87.331)
•Document the type and extent of inflammation to support medical necessity