Is G94 a billable ICD-10-CM code?

Yes. G94 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does G94 sit in the tabular list?

Diseases of the nervous system (G00-G99), in the block Other disorders of the nervous system (G89-G99).

What cannot be coded together with G94?

G94 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

G94

G94 — Other disorders of brain in diseases classified elsewhere

Billable / specific codeICD-10-CM

G94 is a billable, specific ICD-10-CM code for other disorders of brain in diseases classified elsewhere. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

encephalopathy in congenital syphilis (A50.49)
encephalopathy in influenza (J09.X9, J10.81, J11.81)
encephalopathy in syphilis (A52.19)
hydrocephalus in diseases classified elsewhere (G91.4)

Code first

The underlying condition must be sequenced before this code.

underlying disease

Risk adjustment

G94 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

G94 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

Questions about G94

Is G94 a billable ICD-10-CM code?: Yes. G94 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does G94 sit in the tabular list?: Diseases of the nervous system (G00-G99), in the block Other disorders of the nervous system (G89-G99).
What cannot be coded together with G94?: G94 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.