G93.5: Compression of brain

Risk adjustment

G93.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 202 Coma, Brain Compression/Anoxic Damage0.543 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

G93.5 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A56551Billing and Coding: Visual Fields Testing
• A56612Billing and Coding: CT of the Head
• A56722Billing and Coding: Intraoperative Neurophysiological Testing
• A56771Billing and Coding: Special Electroencephalography