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v1.0.0
ICD-10 Guide
ICD-10 CodesA85.1

A85.1

Japanese encephalitis.

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A85.1 is a billable code used to indicate a diagnosis of japanese encephalitis..

Key Diagnostic Point:

Japanese encephalitis (JE) is a viral infection caused by the Japanese encephalitis virus (JEV), primarily transmitted through the bite of infected mosquitoes, particularly in rural agricultural areas of Asia. The disease is characterized by inflammation of the brain, leading to neurological complications that can range from mild to severe. Symptoms typically begin with fever, headache, and vomiting, progressing to neurological manifestations such as seizures, altered consciousness, and paralysis. The incidence of JE is highest in children under 15 years of age, and while many infections are asymptomatic, a significant proportion can lead to severe neurological impairment or death. Vaccination is the most effective preventive measure, especially for individuals living in or traveling to endemic areas. The vaccine is recommended for those at high risk, including travelers and residents in areas where JE is prevalent. Early diagnosis and supportive care are crucial for improving outcomes, as there is no specific antiviral treatment for the infection. Understanding the clinical presentation and vaccination status is essential for accurate coding and management of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between JE and other viral encephalitides.
  • Understanding the vaccination status of the patient.
  • Documenting neurological complications accurately.
  • Identifying the geographic exposure history of the patient.

Audit Risk Factors

  • Inadequate documentation of vaccination status.
  • Failure to document the geographic exposure.
  • Misclassification of the type of encephalitis.
  • Lack of detailed neurological examination findings.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed travel history, vaccination records, and clinical findings.

Common Clinical Scenarios

Patients presenting with fever and neurological symptoms after travel to endemic areas.

Billing Considerations

Ensure vaccination status is clearly documented to support coding.

Neurology

Documentation Requirements

Comprehensive neurological examination and imaging results.

Common Clinical Scenarios

Patients with acute encephalitis symptoms requiring neurological assessment.

Billing Considerations

Document all neurological deficits and complications for accurate coding.

Coding Guidelines

Inclusion Criteria

Use A85.1 When
  • According to ICD
  • 10 coding guidelines, A85
  • 1 should be used when the patient has a confirmed diagnosis of Japanese encephalitis
  • It is important to document the cause of the encephalitis and any relevant travel history

Exclusion Criteria

Do NOT use A85.1 When
  • Exclusion criteria include other viral encephalitides that may require different coding

Related CPT Codes

86788CPT Code

Japanese encephalitis virus antibody test

Clinical Scenario

Used to confirm diagnosis in suspected cases.

Documentation Requirements

Document the reason for testing and clinical findings.

Specialty Considerations

Infectious disease specialists should ensure comprehensive history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Japanese encephalitis, improving the ability to track and manage cases effectively. It emphasizes the importance of detailed documentation regarding travel and vaccination history.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Japanese encephalitis, improving the ability to track and manage cases effectively. It emphasizes the importance of detailed documentation regarding travel and vaccination history.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of Japanese encephalitis, improving the ability to track and manage cases effectively. It emphasizes the importance of detailed documentation regarding travel and vaccination history.

Resources

Clinical References

  • •
    CDC Japanese Encephalitis Information

Coding & Billing References

  • •
    CDC Japanese Encephalitis Information

Frequently Asked Questions

What are the symptoms of Japanese encephalitis?

Symptoms include fever, headache, vomiting, seizures, and altered consciousness. Severe cases can lead to neurological complications.

How is Japanese encephalitis diagnosed?

Diagnosis is typically made through clinical evaluation and confirmed with serological tests or PCR for the virus.

Is there a vaccine for Japanese encephalitis?

Yes, there is a vaccine available, and it is recommended for individuals traveling to or living in endemic areas.