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I97.5 ICD-10-CM Code: Accidental puncture and laceration of a circulatory system organ or structure during a procedure

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
2 Excludes2

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I97.5 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on I97.5 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for I97.5

MedCoder structured workflow — derived from this code’s own official record

Before you code I97.5

  1. I97.5 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewI97.51, I97.52

    See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath I97.5?
    Yes → Select that code and continue the checks below on its own page.
    No → I97.5 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewI97.51, I97.52

Consider I97.5. Then 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).

Official instructions as workflow

  • Excludes2 — not part of I97.5(2 notes)

    Coding workflow: The conditions named in this note are not included in I97.5. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareG97.4, T81.1

    See the official tabular notes · Guidelines I.A.12.b

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.

Code Overview

Accidental puncture and laceration of a circulatory system organ or structure during a procedure is a non-billable ICD-10-CM category code (I97.5). A more specific billable subcode must be selected for claims submission.

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

  • Not billable as written — a more specific code is required: I97.51, I97.52.

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 structured relationships — computed from published CMS and AHRQ datasets

Other codes that name I97.5 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 Excludes1 note: I97.4 — Intraoperative hemorrhage and hematoma of a circulatory system organ or structure complicating a procedure.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 20 Excludes2 notes: T80 — Complications following infusion, transfusion and therapeutic injection (via I97.-), T80 — Complications following infusion, transfusion and therapeutic injection, T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88) (via I97.-), T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88), T81 — Complications of procedures, not elsewhere classified (via I97.-), T81 — Complications of procedures, not elsewhere classified, T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts (via I97.-), T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts, T83 — Complications of genitourinary prosthetic devices, implants and grafts, T83 — Complications of genitourinary prosthetic devices, implants and grafts (via I97.-), T84 — Complications of internal orthopedic prosthetic devices, implants and grafts, T84 — Complications of internal orthopedic prosthetic devices, implants and grafts (via I97.-), T85 — Complications of other internal prosthetic devices, implants and grafts (via I97.-), T85 — Complications of other internal prosthetic devices, implants and grafts, T86 — Complications of transplanted organs and tissue, T86 — Complications of transplanted organs and tissue (via I97.-), T87 — Complications peculiar to reattachment and amputation, T87 — Complications peculiar to reattachment and amputation (via I97.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via I97.-), T88 — Other complications of surgical and medical care, not elsewhere classified.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Contextual Map

Every relationship of I97.5 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 I97.5 with these 6 related codes in Claim Check

Hierarchy

Excludes2

Referenced by Excludes1 notes

Referenced by Excludes2 notes (20)

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can I97.5 be billed directly?

No. I97.5 (Accidental puncture and laceration of a circulatory system organ or structure during a procedure) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) 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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Accidental puncture and laceration of a circulatory system organ or structure during a procedure

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), 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 I97.5 in its code family, with their registry titles.

View all codes in the I97 family