MCMedicalCodingSoftware
G04.91

G04.91: Myelitis, unspecified

Billable / specific codeICD-10-CM

G04.91 is a billable, specific ICD-10-CM code for myelitis, unspecified. It is valid for submission on a claim.

Check G04.91 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above G04.91

A category’s note binds every code beneath it.

Written on G04: Encephalitis, myelitis and encephalomyelitis

Excludes2 inherited from the categories above G04.91

Not part of this code, but both may be coded when both are present.

Written on G04: Encephalitis, myelitis and encephalomyelitis

  • acute transverse myelitis (G37.3)
  • alcoholic encephalopathy (G31.2)
  • multiple sclerosis (G35-)
  • myalgic encephalomyelitis (G93.32)
  • subacute necrotizing myelitis (G37.4)
  • toxic encephalitis (G92.8)
  • toxic encephalopathy (G92.8)

Other codes that can never be billed with G04.91

Their own Excludes1 notes name this code, so the conflict is not listed above.

  • G03Meningitis due to other and unspecified causes

Risk adjustment

G04.91 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

  • HCC 182 Spinal Cord Disorders/Injuries0.478 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

G04.91 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A56551Billing and Coding: Visual Fields Testing
  • A56619Billing and Coding: Nerve Conduction Studies and Electromyography
  • A56695Billing and Coding: Implantable Infusion Pump
  • A56799Billing and Coding: Visual Fields Testing

Alphabetic index entries that lead here

  • Myelitis(acute) (ascending) (childhood) (chronic) (descending) (diffuse) (disseminated) (idiopathic) (pressure) (progressive) (spinal cord) (subacute)
  • Myeloradiculitis
  • Infection, infected, infective›spinal cord NOS

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under G04.9

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.