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

ICD-10 A52.14

Billable / Specific MCC

Late syphilitic encephalitis

A52
Block
0
Synonyms
113
LCDs
14
Payer Policies
44
Linked CPTs

About ICD-10-CM A52.14

ICD-10-CM code A52.14 represents Late syphilitic encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A52). The 2026 edition of ICD-10-CM A52.14 became effective on October 1, 2025.

Coding Tips for A52.14

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

Inpatient DRG impact: MCC

A52.14 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 Late syphilitic 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 A52.14

Local Coverage Determinations (LCDs) from CMS MACs that list A52.14 as a covered diagnosis.

113 LCDs

Showing top 10 of 113 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 A52.14.

14 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Routine Foot Care
Policy ID: ART-52996
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: Special Electroencephalography
Policy ID: ART-56771

CPT Codes Commonly Billed with A52.14

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

44 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
  • 11719 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
  • G0127 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
  • 11056 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
  • 95929 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
  • 92651 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
  • 92653 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
  • 95928 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD

Convert A52.14 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
A52.14 09481 10000

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

ICD-10 A52.14, Billing FAQ

Is ICD-10 code A52.14 billable? +

Yes, A52.14 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is A52.14 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 A52.14? +

Procedures frequently paired with A52.14 include: 92083, 92082, 92081, 11719, G0127.

What ICD-9 codes does A52.14 map to? +

Per CMS GEMs, A52.14 maps to ICD-9 codes: 09481. 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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