I96

Gangrene, not elsewhere classified

FY2027Chapter 9: Diseases of the circulatory system/I95–I99 Other and unspecified disorders of the circulatory system

BillableComplete code, valid to report

I96 is a billable ICD-10-CM diagnosis code for gangrene, not elsewhere classified. It is part of the FY2027 code set, effective October 1, 2026. The Alphabetic Index lists it under 13 entries. Its coding notes include 6 Excludes1 entries and 11 Excludes2 entries.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

This code

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

This code
  • gangrene in diabetes mellitus (E08-E13 with .52)
Also from chapter/block level (10 notes)
Inherited from Chapter 9 Diseases of the circulatory system
  • 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.-)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Wound clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital CC

Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 45 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

IPF Comorbidity

On the CMS IPF comorbidity list.

Comorbidity categoryFactor
Gangrene1.12
It counts as a comorbidity when reported as a secondary diagnosis and actively treated during the stay. An IPF receives only one adjustment within a category and can receive adjustments in more than one category.

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum B-3 (comorbidity codes with adjustment factor); effective for discharges on or after October 1, 2026

Inclusion terms

Conditions classified to this code.

This code
  • Gangrenous cellulitis

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 13 entries

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