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N76.4

Billable

Abscess of vulva

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is N76.4 an HCC code?

No. N76.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

N76.4 is the ICD-10-CM diagnosis code for abscess of vulva. A localized collection of pus or infected fluid that forms in the vulvar tissue, typically requiring drainage or treatment. N76.4 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering inflammatory diseases of female pelvic organs (n70-n77).

N76.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Document whether the abscess is drained, incised, or treated conservatively.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N76.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document whether the abscess is drained, incised, or treated conservatively
  • Identify any associated organisms if culture results are available for more complete documentation

Code Hierarchy

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