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

ICD-10 I97.630

Billable / Specific CC

Postprocedural hematoma of a circulatory system organ or structure following a cardiac catheterization

I97
Block
0
Synonyms
57
LCDs
5
Payer Policies
0
Linked CPTs

About ICD-10-CM I97.630

ICD-10-CM code I97.630 represents Postprocedural hematoma of a circulatory system organ or structure following a cardiac catheterization. This is a billable/specific code in the Circulatory System chapter (block I97). The 2026 edition of ICD-10-CM I97.630 became effective on October 1, 2025.

Coding Tips for I97.630

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

Inpatient DRG impact: CC

I97.630 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.

Inpatient DRG Impact, CC

codes Postprocedural hematoma of a circulatory system organ or structure following a cardiac catheterization. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I97.630

Local Coverage Determinations (LCDs) from CMS MACs that list I97.630 as a covered diagnosis.

57 LCDs

Showing top 10 of 57 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I97.630.

5 policies

5 Medicare

Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Aortography and Peripheral Angiography
Policy ID: ART-57056
Billing and Coding: Electrocardiograms
Policy ID: ART-57326
Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies
Policy ID: ART-57593
Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
Policy ID: ART-57594

CPT Codes Commonly Billed with I97.630

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

No procedure linkages on file for I97.630

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 I97.630 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I97.630 99812 10000

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

ICD-10 I97.630, Billing FAQ

Is ICD-10 code I97.630 billable? +

Yes, I97.630 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is I97.630 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 I97.630 map to? +

Per CMS GEMs, I97.630 maps to ICD-9 codes: 99812. 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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