G04
G04: Encephalitis, myelitis and encephalomyelitis
Non-billable headerICD-10-CM
G04 is a non-billable header ICD-10-CM code for encephalitis, myelitis and encephalomyelitis. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- encephalopathy NOS (G93.40)
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Includes
Conditions this code covers.
- acute ascending myelitis
- meningoencephalitis
- meningomyelitis
Other codes that can never be billed with G04
Their own Excludes1 notes name this code, so the conflict is not listed above.
- G00Bacterial meningitis, not elsewhere classified
- G03Meningitis due to other and unspecified causes
- G04.0Acute disseminated encephalitis and encephalomyelitis (ADEM)
- G36Other acute disseminated demyelination
- G37.3Acute transverse myelitis in demyelinating disease of central nervous system
- A80Acute poliomyelitis
- G04.3Acute necrotizing hemorrhagic encephalopathy
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead G04
6 child codes. Green means billable.
- G04.0Acute disseminated encephalitis and encephalomyelitis (ADEM)
- G04.1Tropical spastic paraplegia
- G04.2Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified
- G04.3Acute necrotizing hemorrhagic encephalopathy
- G04.8Other encephalitis, myelitis and encephalomyelitis
- G04.9Encephalitis, myelitis and encephalomyelitis, unspecified