ICD-10 code for encephalopathy

The ICD-10-CM code for encephalopathy is G93.40 (Encephalopathy, unspecified). The official index lists 6 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on G93.40.

Within G93.4, choose G93.40 (Encephalopathy, unspecified) only when documentation doesn't support a more specific option: metabolic encephalopathy (G93.41), Megalencephalic leukoencephalopathy with subcortical cysts (G93.42), leukoencephalopathy with calcifications and cysts (G93.43), Adult-onset leukodystrophy with axonal spheroids (G93.44), developmental and epileptic encephalopathy (G93.45) and other encephalopathy (G93.49).

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 070 (Other Cerebrovascular Disorders with MCC, relative weight 1.6093), DRG 071 (Other Cerebrovascular Disorders with CC, relative weight 1.0177), DRG 072 (Other Cerebrovascular Disorders without CC/MCC, relative weight 0.7348), DRG 974 (HIV with Major Related Condition with MCC, relative weight 3.0506), DRG 975 (HIV with Major Related Condition with CC, relative weight 1.3252) and DRG 976 (HIV with Major Related Condition without CC/MCC, relative weight 0.8124), in MDC 01 (Diseases and Disorders of the Nervous System) and MDC 25 (Human Immunodeficiency Virus Infections), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.