G91.4: Hydrocephalus in diseases classified elsewhere
G91.4 is a billable, specific ICD-10-CM code for hydrocephalus in diseases classified elsewhere. It is valid for submission on a claim.
Check G91.4 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- hydrocephalus due to congenital toxoplasmosis (P37.1)
Code first
The underlying condition must be sequenced before this code.
Other codes that can never be billed with G91.4
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
G91.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 127 Dementia, Mild or Unspecified0.341 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
G91.4 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56612Billing and Coding: CT of the Head
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
- A57780Billing and Coding: Psychological and Neuropsychological Tests
Alphabetic index entries that lead here
- Hydrocephalus›secondary
- Hydrocephalus›in›neoplastic disease NEC(see also Neoplasm)
Code history
Unchanged in every release from FY2024 to FY2027.