Is G96.1 a billable ICD-10-CM code?

No. G96.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does G96.1 sit in the tabular list?

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

G96.1

G96.1 — Disorders of meninges, not elsewhere classified

Non-billable headerICD-10-CM

G96.1 is a non-billable header ICD-10-CM code for disorders of meninges, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

G96.1 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.

Code to one of these instead G96.1

3 child codes. Green means billable.

G96.11Dural tear
G96.12Meningeal adhesions (cerebral) (spinal)
G96.19Other disorders of meninges, not elsewhere classified

Related codes at this level

Codes that share G96. If G96.1 is not quite right, the correct code is usually one of these.

G96.0Cerebrospinal fluid leak
G96.8Other specified disorders of central nervous system
G96.9Disorder of central nervous system, unspecified

Questions about G96.1

Is G96.1 a billable ICD-10-CM code?: No. G96.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does G96.1 sit in the tabular list?: Diseases of the nervous system (G00-G99), in the block Other disorders of the nervous system (G89-G99).