I86.4 — Gastric varices
I86.4 is a billable, specific ICD-10-CM code for gastric varices. It is valid for submission on a claim.
Risk adjustment
I86.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
I86.4 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56697Billing and Coding: Non-Invasive Vascular Studies
- A56758Billing and Coding: Non-Invasive Vascular Studies
How I86.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to I86.4.
- Varix›gastric
- Varix›stomach
Related codes at this level
Codes that share I86. If I86.4 is not quite right, the correct code is usually one of these.
Questions about I86.4
- Is I86.4 a billable ICD-10-CM code?
- Yes. I86.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I86.4 sit in the tabular list?
- Diseases of the circulatory system (I00-I99), in the block Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89).