N76.82
BillableFournier disease of vagina and vulva
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is N76.82 an HCC code?
Yes. N76.82 maps to Bone/Joint/Muscle Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for N76.82
For N76.82 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 N76.82 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
N76.82 is the ICD-10-CM diagnosis code for fournier disease of vagina and vulva. A serious, rapidly spreading bacterial infection of the vulva and surrounding tissues that requires urgent medical attention and often surgical intervention. N76.82 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).
Under the CMS-HCC V28 risk adjustment model, N76.82 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.209. Under the older V24 model, N76.82 mapped to the same category but with a base RAF weight of 0.482 — 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.
This is a medical emergency; ensure documentation reflects the acute and severe nature. Because N76.82 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 N76.82 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a medical emergency; ensure documentation reflects the acute and severe nature
- •Code any associated sepsis, necrotizing fasciitis, or systemic complications separately
Clinical Significance
Fournier disease affecting female genitalia represents a life-threatening necrotizing fasciitis requiring emergency surgical intervention and intensive care management. The high mortality and morbidity associated with this condition makes it critical for accurate risk assessment and resource allocation.
Documentation Requirements
- ✓Clinical diagnosis of necrotizing fasciitis of vulva/vagina
- ✓Documentation of tissue necrosis and gangrene in female genitalia
- ✓Evidence of rapid progression and systemic involvement
- ✓Surgical debridement records and extent of tissue removal
- ✓Antibiotic therapy and response to treatment
- ✓Assessment of sepsis or systemic complications
- ✓Imaging studies showing extent of infection
- ✓Multidisciplinary care coordination documentation