Is A85.0 a billable ICD-10-CM code?

Yes. A85.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does A85.0 sit in the tabular list?

Certain infectious and parasitic diseases (A00-B99), in the block Viral and prion infections of the central nervous system (A80-A89).

What cannot be coded together with A85.0?

A85.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above A85.0 (A85) and apply to it just the same.

A85.0

A85.0 — Enteroviral encephalitis

Billable / specific codeICD-10-CM

A85.0 is a billable, specific ICD-10-CM code for enteroviral encephalitis. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Enteroviral encephalomyelitis

Excludes1 inherited from the categories above A85.0

These are not written on A85.0, but they bind it: a note on a category applies to every code beneath it. Billing A85.0 with anything listed here is a denial.

Written on A85 — Other viral encephalitis, not elsewhere classified

encephalitis due to cytomegalovirus (B25.8)
encephalitis due to herpesvirus NEC (B10.0-)
encephalitis due to herpesvirus [herpes simplex] (B00.4)
encephalitis due to measles virus (B05.0)
encephalitis due to mumps virus (B26.2)
encephalitis due to poliomyelitis virus (A80.-)
encephalitis due to zoster (B02.0)
lymphocytic choriomeningitis (A87.2)
myalgic encephalomyelitis (G93.32)

Other codes that can never be billed with A85.0

These codes carry an Excludes1 note pointing at A85.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A85.0 alone.

G05Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

Risk adjustment

A85.0 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

A85.0 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56612Billing and Coding: CT of the Head
A56771Billing and Coding: Special Electroencephalography
A57204Billing and Coding: MRI and CT Scans of the Head and Neck
A57206Billing and Coding: Lumbar MRI

How A85.0 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 A85.0.

Encephalitis›in›enterovirus

Code history

A85.0 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share A85. If A85.0 is not quite right, the correct code is usually one of these.

Questions about A85.0

Is A85.0 a billable ICD-10-CM code?: Yes. A85.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does A85.0 sit in the tabular list?: Certain infectious and parasitic diseases (A00-B99), in the block Viral and prion infections of the central nervous system (A80-A89).
What cannot be coded together with A85.0?: A85.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above A85.0 (A85) and apply to it just the same.