ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesG05.3

G05.3

Billable

Encephalitis and encephalomyelitis in diseases classified elsewhere

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

Code Description

ICD-10 G05.3 is a billable code used to indicate a diagnosis of encephalitis and encephalomyelitis in diseases classified elsewhere.

Key Diagnostic Point:

G05.3 refers to encephalitis and encephalomyelitis that occur as a complication of other diseases. This condition involves inflammation of the brain (encephalitis) and the spinal cord (encephalomyelitis), which can result from various infectious agents, autoimmune processes, or as a secondary effect of systemic diseases. Common causes include viral infections such as herpes simplex virus, arboviruses, and other pathogens that may lead to central nervous system (CNS) infections. Symptoms often include fever, headache, confusion, seizures, and neurological deficits. Diagnosis typically involves clinical evaluation, imaging studies like MRI, and lumbar puncture for cerebrospinal fluid analysis. Treatment may include antiviral medications, corticosteroids, and supportive care, depending on the underlying cause. Accurate coding is essential for proper reimbursement and tracking of these complex conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying diseases that can lead to encephalitis.
  • Need for precise documentation of the primary disease causing encephalitis.
  • Differentiation between encephalitis and other CNS infections.
  • Potential for overlapping symptoms with other neurological conditions.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to specify the type of encephalitis.
  • Incorrect linking of symptoms to the wrong diagnosis.
  • Lack of supporting evidence for the diagnosis in medical records.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed clinical notes, imaging results, and lab findings must be documented.

Common Clinical Scenarios

Patients presenting with fever, altered mental status, and neurological deficits.

Billing Considerations

Neurologists must ensure that the primary disease is clearly identified to support the use of G05.3.

Infectious Disease

Documentation Requirements

Comprehensive history of infections, lab results, and treatment plans.

Common Clinical Scenarios

Patients with known infectious diseases presenting with neurological symptoms.

Billing Considerations

Infectious disease specialists should document the infectious agent and its relation to encephalitis.

Coding Guidelines

Inclusion Criteria

Use G05.3 When
  • According to ICD
  • 10 guidelines, G05
  • 3 should be used when encephalitis or encephalomyelitis is a complication of another disease
  • Coders must ensure that the primary disease is documented and linked appropriately

Exclusion Criteria

Do NOT use G05.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to obtain CSF for analysis in suspected encephalitis cases.

Documentation Requirements

Document indication for lumbar puncture and results of CSF analysis.

Specialty Considerations

Neurologists and infectious disease specialists should ensure thorough documentation of the procedure and findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of encephalitis and its complications, improving the accuracy of data collection and reimbursement processes. G05.3 provides a clear pathway for coding encephalitis related to other diseases, enhancing clinical understanding and management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of encephalitis and its complications, improving the accuracy of data collection and reimbursement processes. G05.3 provides a clear pathway for coding encephalitis related to other diseases, enhancing clinical understanding and management.

Reimbursement & Billing Impact

reimbursement processes. G05.3 provides a clear pathway for coding encephalitis related to other diseases, enhancing clinical understanding and management.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should G05.3 be used?

G05.3 should be used when encephalitis or encephalomyelitis is a complication of another disease, and the underlying condition is clearly documented.