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I96BillableSave

I96 - Gangrene, not elsewhere classified

ICD-10-CM Chapter 9: Diseases of the circulatory system · I95-I99 Other and unspecified disorders of the circulatory system (I95-I99) · Top-level category · FY2027

Applicable To

Inclusion terms listed under I96 in the ICD-10-CM tabular list.

  • Gangrenous cellulitis

Includes, Excludes and Coding Notes

Excludes 1 — Not Coded HereFrom I96

Mutually exclusive: these conditions are never reported together with this code.

  • 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)
Excludes 2 — Not Included HereFrom I96

Not part of this code; report both codes when the patient has both conditions.

  • gangrene in diabetes mellitus (E08-E13 with .52)
Excludes 2 — Not Included HereFrom Chapter I00-I99

Not part of this code; report both codes when the patient has both conditions.

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

Inpatient DRG Payments

DRG 30019,506 discharges

Peripheral Vascular Disorders With Cc

Avg. Medicare Payment

$8,304

Total Payment$10,493
Patient Responsibility$2,189
Hospital Charge$49,396
DRG 29915,558 discharges

Peripheral Vascular Disorders With Mcc

Avg. Medicare Payment

$12,829

Total Payment$15,571
Patient Responsibility$2,742
Hospital Charge$75,125
DRG 3013,898 discharges

Peripheral Vascular Disorders Without Cc/mcc

Avg. Medicare Payment

$5,303

Total Payment$7,396
Patient Responsibility$2,093
Hospital Charge$37,098

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with I96.