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ICD-10-CM I96: Gangrene, not elsewhere classified

I96 is the billable ICD-10-CM code for gangrene, not elsewhere classified, in category I96 (Gangrene, not elsewhere classified) of the Other and unspecified disorders of the circulatory system section. As a principal diagnosis it groups to MS-DRG 299 Peripheral Vascular Disorders with MCC, MS-DRG 300 Peripheral Vascular Disorders with CC, MS-DRG 301 Peripheral Vascular Disorders without CC/MCC (MDC 05 MDC 05: Diseases and Disorders of the Circulatory System); or MS-DRG 791 Prematurity with Major Problems, MS-DRG 793 Full Term Neonate with Major Problems (MDC 15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period). It maps to HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 45 principal diagnoses. 22 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
I96
billable FY2027 ICD-10-CM code
Category
I96 Gangrene, not elsewhere classified
Chapter
9: Diseases of the circulatory system (I00-I99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 263
POA reporting
Required

Tabular list notes for I96

Inclusion terms
  • Gangrenous cellulitis
Excludes1 (never coded together)
  • gangrene in atherosclerosis of native arteries of the extremities (I70.26)
  • gangrene in hernia (K40.1, K40.4, K41.1, K41.4, K42.1, K43.1-, K44.1, K45.1, K46.1)
  • gangrene in other peripheral vascular diseases (I73.-)
  • gangrene of certain specified sites - see Alphabetical Index
  • gas gangrene (A48.0)
  • pyoderma gangrenosum (L88)
Excludes2 (not part of this condition, may be coded together)
  • gangrene in diabetes mellitus (E08-E13 with .52)

MS-DRG grouping when I96 is the principal diagnosis

MS-DRG v44 groups for I96 as principal diagnosis
MDCMS-DRGs
05 MDC 05: Diseases and Disorders of the Circulatory System299300301
15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period791793

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for I96 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, I96 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 45 codes in its exclusion list. Check I96 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, I96 maps to HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list I96

22 current Medicare billing and coding articles list I96 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM I96 mean?

I96 means gangrene, not elsewhere classified. The tabular list also files these terms under it: Gangrenous cellulitis. It is one of 1 billable codes under I96, gangrene, not elsewhere classified.

What can't be coded with I96?

Excludes1 at I96: gangrene in atherosclerosis of native arteries of the extremities (I70.26); gangrene in hernia (K40.1, K40.4, K41.1, K41.4, K42.1, K43.1-, K44.1, K45.1, K46.1); gangrene in other peripheral vascular diseases (I73.-); gangrene of certain specified sites - see Alphabetical Index and 2 more. These are never reported together with I96.

Which MS-DRG does I96 group to?

As the principal diagnosis, I96 groups to MS-DRG 299 Peripheral Vascular Disorders with MCC, MS-DRG 300 Peripheral Vascular Disorders with CC, MS-DRG 301 Peripheral Vascular Disorders without CC/MCC (MDC 05 MDC 05: Diseases and Disorders of the Circulatory System); or MS-DRG 791 Prematurity with Major Problems, MS-DRG 793 Full Term Neonate with Major Problems (MDC 15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does I96 map to an HCC?

Yes: HCC 263, Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene, in the PY2027 CMS-HCC V28 mapping.

Is I96 a CC or MCC?

I96 is a CC under MS-DRG v44; 45 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.