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ICD-10 Guide
ICD-10 CodesA81.8

A81.8

Other viral encephalitis, not elsewhere classified

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

Code Description

ICD-10 A81.8 is a billable code used to indicate a diagnosis of other viral encephalitis, not elsewhere classified.

Key Diagnostic Point:

A81.8 refers to viral encephalitis caused by viruses that are not classified under other specific categories. This condition is characterized by inflammation of the brain, which can lead to neurological complications such as seizures, cognitive deficits, and motor dysfunction. The etiology of viral encephalitis can include various viruses such as enteroviruses, arboviruses, and others that do not fit into the more commonly recognized categories like herpes simplex virus or West Nile virus. Symptoms may range from mild flu-like signs to severe neurological impairment, and diagnosis typically involves clinical evaluation, imaging studies, and laboratory tests to identify the causative agent. Vaccination status is crucial, as certain viral encephalitides can be prevented through vaccination, such as those caused by the Japanese encephalitis virus. Understanding the patient's vaccination history can aid in determining the risk factors and potential causative agents of the encephalitis. Treatment is primarily supportive, focusing on managing symptoms and preventing complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential viral etiologies
  • Overlap with other encephalitis codes
  • Need for detailed clinical documentation
  • Potential for misclassification with other CNS infections

Audit Risk Factors

  • Inadequate documentation of viral etiology
  • Failure to note vaccination history
  • Misdiagnosis or misclassification of encephalitis type
  • Lack of supporting lab results

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and laboratory tests confirming viral etiology.

Common Clinical Scenarios

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

Billing Considerations

Neurologists should ensure comprehensive documentation of symptoms and diagnostic tests to support the diagnosis of viral encephalitis.

Infectious Disease

Documentation Requirements

History of exposure to infectious agents, vaccination status, and laboratory confirmation of viral infection.

Common Clinical Scenarios

Patients with recent travel history or exposure to vectors known to transmit encephalitic viruses.

Billing Considerations

Infectious disease specialists must document the clinical context and any relevant epidemiological data.

Coding Guidelines

Inclusion Criteria

Use A81.8 When
  • According to ICD
  • 10 guidelines, A81
  • 8 should be used when the specific viral cause of encephalitis is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that other specific codes are not applicable

Exclusion Criteria

Do NOT use A81.8 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

Viral panel testing

Clinical Scenario

Used when testing for multiple viral pathogens in suspected encephalitis cases.

Documentation Requirements

Document the clinical rationale for testing and the specific viruses being tested.

Specialty Considerations

Infectious disease specialists should ensure that the testing aligns with 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 trends and outcomes. A81.8 provides a distinct code for cases that do not fit into other classifications, improving data accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of viral encephalitis, enabling better tracking of epidemiological trends and outcomes. A81.8 provides a distinct code for cases that do not fit into other classifications, improving data accuracy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of viral encephalitis, enabling better tracking of epidemiological trends and outcomes. A81.8 provides a distinct code for cases that do not fit into other classifications, improving data accuracy.

Resources

Clinical References

  • •
    CDC Viral Encephalitis Information

Coding & Billing References

  • •
    CDC Viral Encephalitis Information

Frequently Asked Questions

What is the significance of vaccination status in coding A81.8?

Vaccination status is crucial as it can indicate the risk of certain viral infections that lead to encephalitis. Documenting whether a patient has been vaccinated against specific viruses can help in determining the etiology and guiding treatment.