G36.0: Neuromyelitis optica [Devic]
G36.0 is a billable, specific ICD-10-CM code for neuromyelitis optica [devic]. It is valid for submission on a claim.
Check G36.0 with the rest of the claim: free scrubberExcludes2: 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.
- optic neuritis NOS (H46)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Demyelination in optic neuritis
Other codes that can never be billed with G36.0
Their own Excludes1 notes name this code, so the conflict is not listed above.
- G37.3Acute transverse myelitis in demyelinating disease of central nervous system
Risk adjustment
G36.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 198 Multiple Sclerosis0.647 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
G36.0 is named in 26 Medicare coverage policies: 26 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53052Billing and Coding: Home Health Speech-Language Pathology
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A54548Billing and Coding: Eculizumab, and Biosimilars: EPYSQLI®-eculizumab-aagh, and BKEMV™-eculizumab-aeeb
- A54969Billing and Coding: Nerve Conduction Studies and Electromyography
Alphabetic index entries that lead here
- Devic's disease
- Neuroencephalomyelopathy, optic
- Ophthalmoneuromyelitis
- Demyelination, demyelinization›in optic neuritis
- Disease, diseased›Devic's
- Myelitis›optic neuritis in
- Neuromyelitis›optica
- Neuritis›optic›in myelitis
- Neuritis›optic›with demyelination
Code history
Unchanged in every release from FY2024 to FY2027.