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ICD-10 Guide
ICD-10 CodesA85.8

A85.8

Other specified viral encephalitis

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

Code Description

ICD-10 A85.8 is a billable code used to indicate a diagnosis of other specified viral encephalitis.

Key Diagnostic Point:

A85.8 refers to other specified viral encephalitis, which encompasses a variety of viral infections that lead to inflammation of the brain. This condition can arise from numerous viral pathogens, including but not limited to arboviruses, enteroviruses, and herpesviruses. Patients may present with a range of neurological symptoms such as fever, headache, confusion, seizures, and altered mental status. The diagnosis is typically confirmed through clinical evaluation, imaging studies like MRI, and laboratory tests including PCR for viral DNA or RNA. The management of viral encephalitis often involves supportive care, and in some cases, antiviral therapy may be indicated depending on the causative virus. Vaccination status is crucial, as certain viral encephalitides can be prevented through vaccination, such as the Japanese encephalitis vaccine. Understanding the specific viral etiology is essential for prognosis and treatment, as well as for public health considerations in outbreak scenarios.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential viral etiologies requiring specific identification.
  • Need for comprehensive clinical documentation to support diagnosis.
  • Differentiation from other types of encephalitis and CNS infections.
  • Potential overlap with other neurological conditions.

Audit Risk Factors

  • Inadequate documentation of viral etiology.
  • Failure to specify vaccination status.
  • Misclassification with other CNS infections.
  • Lack of supporting laboratory results.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and laboratory test outcomes.

Common Clinical Scenarios

Patients presenting with acute neurological symptoms, suspected viral infections, or post-infectious complications.

Billing Considerations

Ensure clarity in documenting the specific viral agent and any relevant vaccination history.

Infectious Disease

Documentation Requirements

Comprehensive history of exposure, vaccination status, and laboratory confirmation of viral infection.

Common Clinical Scenarios

Outbreak investigations, patients with travel history to endemic areas, or those with atypical presentations.

Billing Considerations

Highlight the importance of distinguishing between viral and bacterial causes of encephalitis.

Coding Guidelines

Inclusion Criteria

Use A85.8 When
  • According to ICD
  • 10 coding guidelines, A85
  • 8 should be used when the specific viral cause of encephalitis is documented but does not fall under other specified categories

Exclusion Criteria

Do NOT use A85.8 When
  • It is essential to ensure that the documentation supports the diagnosis and that any relevant exclusion criteria are met

Related CPT Codes

87491CPT Code

Viral culture, any type

Clinical Scenario

Used when viral encephalitis is suspected and viral etiology needs to be confirmed.

Documentation Requirements

Document the clinical rationale for testing and any relevant symptoms.

Specialty Considerations

Neurology and Infectious Disease specialists should ensure comprehensive documentation of clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of viral encephalitis, enabling better tracking of epidemiological data and improved patient management. A85.8 provides a distinct code for cases where the viral agent is known but does not fit into other specified categories.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of viral encephalitis, enabling better tracking of epidemiological data and improved patient management. A85.8 provides a distinct code for cases where the viral agent is known but does not fit into other specified categories.

Reimbursement & Billing Impact

reimbursement and compliance.

Resources

Clinical References

  • •
    CDC Viral Encephalitis Information

Coding & Billing References

  • •
    CDC Viral Encephalitis Information

Frequently Asked Questions

What is the difference between A85.8 and A85.0?

A85.8 is used when the specific viral cause of encephalitis is known but does not fall under other specified categories, while A85.0 is used when the viral cause is unspecified.