ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I75.013

Billable / Specific HCC v28: 107 CC

Atheroembolism of bilateral upper extremities

I75
Block
0
Synonyms
288
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM I75.013

ICD-10-CM code I75.013 represents Atheroembolism of bilateral upper extremities. This is a billable/specific code in the Circulatory System chapter (block I75). The 2026 edition of ICD-10-CM I75.013 became effective on October 1, 2025.

Coding Tips for I75.013

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I75.013 is a CMS-HCC v28 risk-adjustment code (category 107). 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.

Inpatient DRG impact: CC

I75.013 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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 107
ESRD-HCC
Category 107
RxHCC (Part D)
Category 107

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 Atheroembolism of bilateral upper extremities. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I75.013

Local Coverage Determinations (LCDs) from CMS MACs that list I75.013 as a covered diagnosis.

288 LCDs

Showing top 10 of 288 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93926 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93930 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60318, Effective: , 409 covered, 1 non-covered
CPT 93931 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93926 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93930 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93925 →
CMS LCD: Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities
Article ID: 60314, Effective: , 409 covered, 1 non-covered
CPT 93931 →
CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies
Article ID: 57593, Effective: 2025-10-01 00:00:00, 593 covered, 0 non-covered
CPT 93924 →
CMS LCD: Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies
Article ID: 57593, Effective: 2025-10-01 00:00:00, 593 covered, 0 non-covered
CPT 93925 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I75.013.

14 policies

2 Cigna

Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-56500
Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56697
Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56758
Billing and Coding: Electrocardiograms
Policy ID: ART-57326

CPT Codes Commonly Billed with I75.013

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for I75.013

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert I75.013 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I75.013 44501 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To I75.013

Other codes in section I70-I79 (Diseases of arteries, arterioles and capillaries).

I70 Atherosclerosis (non-billable) I70.0 Atherosclerosis of aorta I70.1 Atherosclerosis of renal artery I70.2 Atherosclerosis of native arteries of the extremities (non-billable) I70.20 Unspecified atherosclerosis of native arteries of extremities (non-billable) I70.201 Unspecified atherosclerosis of native arteries of extremities, right leg I70.202 Unspecified atherosclerosis of native arteries of extremities, left leg I70.203 Unspecified atherosclerosis of native arteries of extremities, bilateral legs I70.208 Unspecified atherosclerosis of native arteries of extremities, other extremity I70.209 Unspecified atherosclerosis of native arteries of extremities, unspecified extremity I70.21 Atherosclerosis of native arteries of extremities with intermittent claudication (non-billable) I70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg I70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg I70.213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs I70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity I70.219 Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity I70.22 Atherosclerosis of native arteries of extremities with rest pain (non-billable) I70.221 Atherosclerosis of native arteries of extremities with rest pain, right leg I70.222 Atherosclerosis of native arteries of extremities with rest pain, left leg I70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs

ICD-10 I75.013, Billing FAQ

Is ICD-10 code I75.013 billable? +

Yes, I75.013 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does I75.013 affect Medicare Advantage HCC risk adjustment? +

Yes. I75.013 maps to CMS-HCC v28 category 107. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is I75.013 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 ICD-9 codes does I75.013 map to? +

Per CMS GEMs, I75.013 maps to ICD-9 codes: 44501. Useful for legacy data review and historical claim analysis.

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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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