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ICD-10 Guide
ICD-10 CodesB01.11

B01.11

Varicella encephalitis and encephalomyelitis

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

Code Description

ICD-10 B01.11 is a billable code used to indicate a diagnosis of varicella encephalitis and encephalomyelitis.

Key Diagnostic Point:

Varicella encephalitis and encephalomyelitis are serious complications of varicella (chickenpox) infection, primarily caused by the varicella-zoster virus (VZV). These conditions can occur in both immunocompetent and immunocompromised individuals, although they are more common in the latter. Encephalitis refers to inflammation of the brain, while encephalomyelitis involves inflammation of both the brain and spinal cord. Symptoms may include fever, headache, altered mental status, seizures, and focal neurological deficits. Diagnosis is typically confirmed through clinical evaluation, imaging studies such as MRI, and laboratory tests including PCR for VZV in cerebrospinal fluid. Prompt recognition and treatment are crucial, as these conditions can lead to significant morbidity and mortality. Management often involves antiviral therapy, supportive care, and monitoring for potential complications such as seizures or neurological deficits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between encephalitis and encephalomyelitis
  • Need for precise documentation of neurological symptoms
  • Potential for co-infection with other viruses
  • Variability in clinical presentation based on patient immune status

Audit Risk Factors

  • Inadequate documentation of neurological symptoms
  • Failure to specify immunocompromised status
  • Misclassification of encephalitis vs. encephalomyelitis
  • Lack of supporting laboratory or imaging results

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure clear documentation of the timeline of varicella infection and neurological symptoms.

Infectious Disease

Documentation Requirements

History of varicella infection, immunization status, and any co-morbid conditions.

Common Clinical Scenarios

Immunocompromised patients with varicella presenting with neurological symptoms.

Billing Considerations

Document any antiviral treatments and their effects on the patient's condition.

Coding Guidelines

Inclusion Criteria

Use B01.11 When
  • According to ICD
  • 10 guidelines, B01
  • 11 should be used when there is a confirmed diagnosis of varicella encephalitis or encephalomyelitis
  • It is important to document the clinical findings and any laboratory results that support the diagnosis

Exclusion Criteria

Do NOT use B01.11 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

Viral culture for varicella-zoster virus

Clinical Scenario

Used when confirming varicella infection in a patient with 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, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of varicella-related complications, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC Varicella (Chickenpox) Information

Coding & Billing References

  • •
    CDC Varicella (Chickenpox) Information

Frequently Asked Questions

What are the common symptoms of varicella encephalitis?

Common symptoms include fever, headache, confusion, seizures, and focal neurological deficits. These symptoms may develop after a recent varicella infection.