ICD-10 I24.81
Billable / Specific HCC v28: 87 CCAcute coronary microvascular dysfunction
About ICD-10-CM I24.81
ICD-10-CM code I24.81 represents Acute coronary microvascular dysfunction. This is a billable/specific code in the Circulatory System chapter (block I24). The 2026 edition of ICD-10-CM I24.81 became effective on October 1, 2025.
Coding Tips for I24.81
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I24.81 is a CMS-HCC v28 risk-adjustment code (category 87). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
I24.81 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under I24.81. Per CMS ICD-10-CM Tabular 2026.
- Acute (presentation of) coronary microvascular disease
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Acute coronary microvascular dysfunction. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I24.81
Local Coverage Determinations (LCDs) from CMS MACs that list I24.81 as a covered diagnosis.
Showing top 10 of 630 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I24.81.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with I24.81
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 92979 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- C9607 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- C9600 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- 92937 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- 92920 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- C9608 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- 92943 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- C9601 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- 92941 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
- 92973 CMS LCD: Billing and Coding: Percutaneous Coronary Interventions CMS LCD
Codes Adjacent To I24.81
Other codes in section I20-I25 (Ischemic heart diseases).
ICD-10 I24.81, Billing FAQ
Is ICD-10 code I24.81 billable? +
Yes, I24.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to I24.81? +
ICD-10 I24.81 includes: Acute (presentation of) coronary microvascular disease.
Does I24.81 affect Medicare Advantage HCC risk adjustment? +
Yes. I24.81 maps to CMS-HCC v28 category 87. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I24.81 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with I24.81? +
Procedures frequently paired with I24.81 include: 92979, C9607, C9600, 92937, 92920.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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