Is H81.4 a billable ICD-10-CM code?

Yes. H81.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does H81.4 sit in the tabular list?

Diseases of the ear and mastoid process (H60-H95), in the block Diseases of inner ear (H80-H83).

What cannot be coded together with H81.4?

H81.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H81.4 (H81) and apply to it just the same.

H81.4

H81.4 — Vertigo of central origin

Billable / specific codeICD-10-CM

H81.4 is a billable, specific ICD-10-CM code for vertigo of central origin. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Central positional nystagmus

Excludes1 inherited from the categories above H81.4

These are not written on H81.4, but they bind it: a note on a category applies to every code beneath it. Billing H81.4 with anything listed here is a denial.

Written on H81 — Disorders of vestibular function

epidemic vertigo (A88.1)
vertigo NOS (R42)

Other codes that can never be billed with H81.4

These codes carry an Excludes1 note pointing at H81.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading H81.4 alone.

R42Dizziness and giddiness

Risk adjustment

H81.4 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

H81.4 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56497Billing and Coding: Vestibular Function Testing
A56747Billing and Coding: Magnetic Resonance Angiography (MRA)
A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
A56805Billing and Coding: Magnetic Resonance Angiography (MRA)

How H81.4 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to H81.4.

Nystagmus›central positional
Vertigo›central(origin)
Vertigo›cerebral
Vertigo›malignant positional
Nystagmus›positional›benign paroxysmal
Nystagmus›positional›central
Vertigo›positional›malignant

Code history

H81.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share H81. If H81.4 is not quite right, the correct code is usually one of these.

Questions about H81.4

Is H81.4 a billable ICD-10-CM code?: Yes. H81.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does H81.4 sit in the tabular list?: Diseases of the ear and mastoid process (H60-H95), in the block Diseases of inner ear (H80-H83).
What cannot be coded together with H81.4?: H81.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above H81.4 (H81) and apply to it just the same.