ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 A39.81

Billable / Specific MCC

Meningococcal encephalitis

A39
Block
0
Synonyms
593
LCDs
9
Payer Policies
33
Linked CPTs

About ICD-10-CM A39.81

ICD-10-CM code A39.81 represents Meningococcal encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A39). The 2026 edition of ICD-10-CM A39.81 became effective on October 1, 2025.

Coding Tips for A39.81

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: MCC

A39.81 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, MCC

codes Meningococcal encephalitis. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for A39.81

Local Coverage Determinations (LCDs) from CMS MACs that list A39.81 as a covered diagnosis.

593 LCDs

Showing top 10 of 593 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT Q9953 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT 72148 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT A9585 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT 72158 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT 72149 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87555 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87653 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87486 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87626 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 0109U →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing A39.81.

9 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Special Electroencephalography
Policy ID: ART-56771
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Lumbar MRI
Policy ID: ART-57206
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58710

CPT Codes Commonly Billed with A39.81

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

33 linkages
  • 70491 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70487 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70490 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70481 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70480 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70482 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70486 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70557 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70488 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD
  • 70558 CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck CMS LCD

Convert A39.81 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
A39.81 0361 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 A39.81, Billing FAQ

Is ICD-10 code A39.81 billable? +

Yes, A39.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is A39.81 a CC or MCC for inpatient DRG? +

Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with A39.81? +

Procedures frequently paired with A39.81 include: 70491, 70487, 70490, 70481, 70480.

What ICD-9 codes does A39.81 map to? +

Per CMS GEMs, A39.81 maps to ICD-9 codes: 0361. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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