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

ICD-10 A52.12

Billable / Specific CC

Other cerebrospinal syphilis

A52
Block
0
Synonyms
67
LCDs
7
Payer Policies
25
Linked CPTs

About ICD-10-CM A52.12

ICD-10-CM code A52.12 represents Other cerebrospinal syphilis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A52). The 2026 edition of ICD-10-CM A52.12 became effective on October 1, 2025.

Coding Tips for A52.12

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

Inpatient DRG impact: CC

A52.12 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Other cerebrospinal syphilis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for A52.12

Local Coverage Determinations (LCDs) from CMS MACs that list A52.12 as a covered diagnosis.

67 LCDs

Showing top 10 of 67 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11719 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11721 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11057 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11720 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT G0127 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11055 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11056 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92082 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92083 →
CMS LCD: Billing and Coding: Visual Fields Testing
Article ID: 56551, Effective: 2025-10-01 00:00:00, 1427 covered, 0 non-covered
CPT 92081 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing A52.12.

7 policies

5 Medicare

Billing and Coding: Foot Care
Policy ID: ART-56232
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Routine Foot Care
Policy ID: ART-56680
Billing and Coding: Urodynamics
Policy ID: ART-56802
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with A52.12

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

25 linkages
  • 92083 CMS LCD: Billing and Coding: Visual Field Examination CMS LCD
  • 92082 CMS LCD: Billing and Coding: Visual Field Examination CMS LCD
  • 92081 CMS LCD: Billing and Coding: Visual Field Examination CMS LCD
  • 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

Convert A52.12 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
A52.12 09489 10000

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

ICD-10 A52.12, Billing FAQ

Is ICD-10 code A52.12 billable? +

Yes, A52.12 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is A52.12 a CC or MCC for inpatient DRG? +

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

What CPT codes are commonly billed with A52.12? +

Procedures frequently paired with A52.12 include: 92083, 92082, 92081, 70491, 70487.

What ICD-9 codes does A52.12 map to? +

Per CMS GEMs, A52.12 maps to ICD-9 codes: 09489. 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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