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.

Check G94 with the rest of the claim: free scrubber

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

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

G94 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

Code history

Unchanged in every release from FY2024 to FY2027.