I85.10 ICD-10-CM Code: Secondary esophageal varices without bleeding
Compare with another codeCheck this code on a claim
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 2 use-additional codes · 1 code-first instruction
- Risk adjustment
- CMS-HCC V28: 1 category · CMS-HCC V22 category 27
Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.
What you need to know
Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.
- Code firstSequence the underlying condition before this code
- underlying disease
- Use additional codeReport with this code when documented
- code to identify:
- alcohol abuse and dependence (F10.-)
Most relevant related codes MedCoder-derived
Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.
- MS-DRG 393 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC (MDC 06)
- MS-DRG 394 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC (MDC 06)
- MS-DRG 395 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC (MDC 06)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Risk Adjustment (CMS-HCC)
Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.
- HCC 63 — Chronic Liver Failure/End-Stage Liver Disorders (supersedes HCC 64, HCC 65, HCC 68, HCC 202)
Other models: CMS-HCC V22 HCC 27
Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I85.10 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026
Trace:FY2027 changesChange historyRelease, file and checksum
Notes without a marker are published on I85.10 itself; “inherited from” names the category or block whose note applies here.
Code First
Underlying conditions that must be sequenced before this code.
- underlying disease
Source: inherited from I85.1
Use Additional Code
Supplementary codes the tabular list directs you to add.
- Use additional code to identify:
- alcohol abuse and dependence (F10.-)
Source: inherited from I85
Coder workflow for I85.10
MedCoder structured workflow — derived from this code’s own official record
Choose the right path
- Is the underlying (etiologic) condition the Code First note names documented?
Yes → Sequence the underlying condition first, then I85.10.
No → Continue; do not add an underlying condition the record does not document.
Consider I85.10. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- The associated condition or complication
- Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
- The underlying (etiologic) condition
- Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Official instructions as workflow
Code First — sequencing check(1 note)
Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before I85.10. Do not add an underlying condition the record does not document.
See the official tabular notes · Guidelines I.A.13
Use Additional Code — after identifying I85.10(2 notes)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I85.10 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
ReviewF10
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: The underlying condition the Code First note names is documented alongside this condition.
Coding question: How are the two sequenced?
Path: Review the Code First note.
Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with I85.10?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
ReviewF10
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Verify Before Coding
- CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name I85.10 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Excludes2 note: K22 — Other diseases of esophagus (via I85.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
MS-DRG Grouper Relationships (FY2027)
Potential MS-DRG participation — not a DRG assignment.
FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 61 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 3 MS-DRGs: DRG 393 (MDC 06), DRG 394 (MDC 06), DRG 395 (MDC 06).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):CIR039 — Other specified diseases of veins and lymphatics (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical process (MS-DRG)
Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.
E16.4 — Increased secretion of gastrin, I27.841 — Fontan-associated lymphatic dysfunction, I27.848 — Other Fontan-associated condition, I27.849 — Fontan related circulation, unspecified, I85.01 — Esophageal varices with bleeding, I85.11 — Secondary esophageal varices with bleeding, I87.8 — Other specified disorders of veins, I87.9 — Disorder of vein, unspecified, I99.8 — Other disorder of circulatory system, I99.9 — Unspecified disorder of circulatory system, K22.6 — Gastro-esophageal laceration-hemorrhage syndrome, K25.0 — Acute gastric ulcer with hemorrhage, K25.1 — Acute gastric ulcer with perforation, K25.2 — Acute gastric ulcer with both hemorrhage and perforation, K25.3 — Acute gastric ulcer without hemorrhage or perforation, K25.4 — Chronic or unspecified gastric ulcer with hemorrhage, K25.5 — Chronic or unspecified gastric ulcer with perforation, K25.6 — Chronic or unspecified gastric ulcer with both hemorrhage and perforation, K25.7 — Chronic gastric ulcer without hemorrhage or perforation, K25.9 — Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation, +40 more
Same CMS-HCC risk category (V28)
CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Liver Failure/End-Stage Liver Disorders) for risk-adjusted payment.
I85.00 — Esophageal varices without bleeding, I85.01 — Esophageal varices with bleeding, I85.11 — Secondary esophageal varices with bleeding, K70.40 — Alcoholic hepatic failure without coma, K70.41 — Alcoholic hepatic failure with coma, K72.10 — Chronic hepatic failure without coma, K72.11 — Chronic hepatic failure with coma, K72.90 — Hepatic failure, unspecified without coma, K72.91 — Hepatic failure, unspecified with coma, K76.6 — Portal hypertension, K76.7 — Hepatorenal syndrome, K76.81 — Hepatopulmonary syndrome, K76.82 — Hepatic encephalopathy
Related risk categories
These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.
Liver Transplant Status/Complications, Coma, Brain Compression/Anoxic Damage, Cirrhosis of Liver, Chronic Hepatitis, Cholangitis and Obstruction of Bile Duct Without Gallstones
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified diseases of veins and lymphatics).
I27.841 — Fontan-associated lymphatic dysfunction, I85.00 — Esophageal varices without bleeding, I85.01 — Esophageal varices with bleeding, I85.11 — Secondary esophageal varices with bleeding, I86.0 — Sublingual varices, I86.1 — Scrotal varices, I86.2 — Pelvic varices, I86.3 — Vulval varices, I86.4 — Gastric varices, I86.8 — Varicose veins of other specified sites, I87.8 — Other specified disorders of veins, I87.9 — Disorder of vein, unspecified, I88.0 — Nonspecific mesenteric lymphadenitis, I88.1 — Chronic lymphadenitis, except mesenteric, I88.8 — Other nonspecific lymphadenitis, I88.9 — Nonspecific lymphadenitis, unspecified, I89.0 — Lymphedema, not elsewhere classified, I89.1 — Lymphangitis, I89.8 — Other specified noninfective disorders of lymphatic vessels and lymph nodes, I89.9 — Noninfective disorder of lymphatic vessels and lymph nodes, unspecified, +4 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Varix”; these codes share that main term but sit in a different category of the Tabular List.
I83.819 — Varicose veins of unspecified lower extremity with pain (with, pain), I83.891 — Varicose veins of right lower extremity with other complications (leg, right, with, edema), I83.892 — Varicose veins of left lower extremity with other complications (leg, left, with, edema), I83.893 — Varicose veins of bilateral lower extremities with other complications (leg, bilateral, with, edema), I83.899 — Varicose veins of unspecified lower extremity with other complications (with, edema), I83.9 — Asymptomatic varicose veins of lower extremities (leg), I83.90 — Asymptomatic varicose veins of unspecified lower extremity, I83.91 — Asymptomatic varicose veins of right lower extremity (leg, right), I83.92 — Asymptomatic varicose veins of left lower extremity (leg, left), I83.93 — Asymptomatic varicose veins of bilateral lower extremities (leg, bilateral), I86.0 — Sublingual varices (sublingual), I86.1 — Scrotal varices (scrotum), I86.2 — Pelvic varices (ovary), I86.3 — Vulval varices (labia), I86.4 — Gastric varices (gastric), I86.8 — Varicose veins of other specified sites (orbit), O22.0 — Varicose veins of lower extremity in pregnancy (complicating, pregnancy), O22.1 — Genital varices in pregnancy (complicating, pregnancy, genital), O22.4 — Hemorrhoids in pregnancy (complicating, pregnancy, anus or rectum), O43.89 — Other placental disorders (placenta), +57 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Fecal Occult Blood Test (FOBT), Gamma-glutamyl Transferase (GGT) Test, Hepatitis Testing
Contextual Map
Every relationship of I85.10 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run I85.10 with this related code in Claim Check
Hierarchy
- I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- I80-I89 — Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Referenced by Excludes2 notes
- K22 — Other diseases of esophagus[Excludes2](via I85.-): “esophageal varices (I85.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Clinical classification (CCSR)
- CIR039 — Other specified diseases of veins and lymphatics[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
Risk adjustment (CMS-HCC)
- HCC 63 — Chronic Liver Failure/End-Stage Liver Disorders [CMS-HCC]: “Chronic Liver Failure/End-Stage Liver Disorders — supersedes HCC 64 (Cirrhosis of Liver), HCC 65 (Chronic Hepatitis), HCC 68 (Cholangitis and Obstruction of Bile Duct Without Gallstones), HCC 202 (Coma, Brain Compression/Anoxic Damage)”— CMS-HCC V28 · 2026
MS-DRG Grouper
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
- DRG 393 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC[MS-DRG]: “OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 394 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC[MS-DRG]: “OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 395 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC[MS-DRG]: “OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
MDC crossing
- MDC 06 — Diseases and Disorders of the Digestive System[MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,748 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
Index entries
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), alcoholic liver disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), cirrhosis of liver[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), portal hypertension[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), schistosomiasis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), toxic liver disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), secondary[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
Nearest codes
- I85 — Esophageal varices[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- I85.0 — Esophageal varices[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- I85.00 — Esophageal varices without bleeding[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- I85.01 — Esophageal varices with bleeding[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- I85.1 — Secondary esophageal varices[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- I85.11 — Secondary esophageal varices with bleeding[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Indexed Clinical Terms (6)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), alcoholic liver disease
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), cirrhosis of liver
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), portal hypertension
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), schistosomiasis
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), in (due to), toxic liver disease
- Varix (lower limb), esophagus (idiopathic) (primary) (ulcerated), secondary
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
- Risk adjustment Official source data
- 2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder-derived relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder editorial explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "I85.10 — Secondary esophageal varices without bleeding." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i85.10-secondary-esophageal-varices-without-bleeding
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionSecondary esophageal varices without bleeding
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to I85.10 in its code family, with their registry titles.