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v1.0.0
ICD-10 Guide
ICD-10 CodesB01.1

B01.1

Varicella encephalitis

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

Code Description

ICD-10 B01.1 is a billable code used to indicate a diagnosis of varicella encephalitis.

Key Diagnostic Point:

Varicella encephalitis is a rare but serious complication of varicella (chickenpox) infection, primarily caused by the varicella-zoster virus (VZV). This condition typically manifests in individuals who have had varicella, particularly in those who are immunocompromised or have not been vaccinated. Symptoms may include fever, headache, confusion, seizures, and focal neurological deficits. The encephalitis can occur during the acute phase of varicella or even after the rash has resolved. Diagnosis is often confirmed through clinical evaluation, cerebrospinal fluid analysis, and imaging studies such as MRI, which may show characteristic changes. Treatment usually involves antiviral medications, supportive care, and management of neurological symptoms. Vaccination against varicella is crucial in preventing this complication, as it significantly reduces the incidence of varicella and its associated complications, including encephalitis. The condition can lead to long-term neurological sequelae in some patients, emphasizing the importance of early recognition and intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between varicella encephalitis and other types of encephalitis.
  • Understanding the clinical presentation and timing of symptoms.
  • Knowledge of vaccination history and its impact on the condition.
  • Navigating the documentation requirements for neurological assessments.

Audit Risk Factors

  • Inadequate documentation of vaccination status.
  • Failure to document neurological symptoms clearly.
  • Misclassification of the type of encephalitis.
  • Lack of supporting lab results or imaging studies.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and lab tests.

Common Clinical Scenarios

Patients presenting with seizures, altered mental status, or focal neurological deficits following varicella.

Billing Considerations

Ensure comprehensive documentation of neurological assessments and any changes in mental status.

Infectious Disease

Documentation Requirements

History of varicella infection, vaccination status, and treatment protocols.

Common Clinical Scenarios

Patients with varicella who develop neurological symptoms or complications.

Billing Considerations

Document the timeline of varicella infection and onset of encephalitis symptoms.

Coding Guidelines

Inclusion Criteria

Use B01.1 When
  • According to ICD
  • 10 guidelines, B01
  • 1 should be used when the encephalitis is directly linked to varicella infection
  • Coders must ensure that the documentation supports the diagnosis and that any related conditions are also coded appropriately

Exclusion Criteria

Do NOT use B01.1 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

Varicella-zoster virus (VZV) PCR

Clinical Scenario

Used to confirm VZV in cases of suspected varicella encephalitis.

Documentation Requirements

Document the reason for testing and any clinical symptoms.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of the patient's history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of varicella-related complications, including encephalitis. This specificity aids in better tracking of cases and understanding the epidemiology of varicella complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of varicella-related complications, including encephalitis. This specificity aids in better tracking of cases and understanding the epidemiology of varicella complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of varicella-related complications, including encephalitis. This specificity aids in better tracking of cases and understanding the epidemiology of varicella complications.

Resources

Clinical References

  • •
    CDC Varicella Information

Coding & Billing References

  • •
    CDC Varicella Information

Frequently Asked Questions

What are the common symptoms of varicella encephalitis?

Common symptoms include fever, headache, confusion, seizures, and focal neurological deficits. Symptoms may vary based on the severity of the condition.

How can varicella encephalitis be prevented?

Vaccination against varicella is the most effective way to prevent varicella encephalitis. The varicella vaccine significantly reduces the incidence of chickenpox and its complications.