ICD-10 I97.811
Billable / Specific HCC v28: 100 CCIntraoperative cerebrovascular infarction during other surgery
About ICD-10-CM I97.811
ICD-10-CM code I97.811 represents Intraoperative cerebrovascular infarction during other surgery. This is a billable/specific code in the Circulatory System chapter (block I97). The 2026 edition of ICD-10-CM I97.811 became effective on October 1, 2025.
Coding Tips for I97.811
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I97.811 is a CMS-HCC v28 risk-adjustment code (category 100). 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.
I97.811 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
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 Intraoperative cerebrovascular infarction during other surgery. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I97.811
Local Coverage Determinations (LCDs) from CMS MACs that list I97.811 as a covered diagnosis.
Showing top 10 of 119 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I97.811.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with I97.811
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 I97.811 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I97.811 | 99702 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I97.811
Other codes in section I95-I99 (Other and unspecified disorders of the circulatory system).
ICD-10 I97.811, Billing FAQ
Is ICD-10 code I97.811 billable? +
Yes, I97.811 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I97.811 affect Medicare Advantage HCC risk adjustment? +
Yes. I97.811 maps to CMS-HCC v28 category 100. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I97.811 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 I97.811 map to? +
Per CMS GEMs, I97.811 maps to ICD-9 codes: 99702. 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 June 1, 2026.
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