J11.81
J11.81: Influenza due to unidentified influenza virus with encephalopathy
Billable / specific codeICD-10-CM
J11.81 is a billable, specific ICD-10-CM code for influenza due to unidentified influenza virus with encephalopathy. It is valid for submission on a claim.
Check J11.81 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Influenzal encephalopathy NOS
Other codes that can never be billed with J11.81
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J11.81 is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56612Billing and Coding: CT of the Head
- A58710Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Alphabetic index entries that lead here
- Influenza›with›encephalopathy
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.