ICD-10 A81.82
Billable / Specific HCC v28: 52 CCGerstmann-Straussler-Scheinker syndrome
About ICD-10-CM A81.82
ICD-10-CM code A81.82 represents Gerstmann-Straussler-Scheinker syndrome. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A81). The 2026 edition of ICD-10-CM A81.82 became effective on October 1, 2025.
Coding Tips for A81.82
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A81.82 is a CMS-HCC v28 risk-adjustment code (category 52). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
A81.82 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under A81.82. Per CMS ICD-10-CM Tabular 2026.
- GSS syndrome
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Gerstmann-Straussler-Scheinker syndrome. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A81.82
Local Coverage Determinations (LCDs) from CMS MACs that list A81.82 as a covered diagnosis.
Showing top 10 of 28 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A81.82.
1 Medicare
CPT Codes Commonly Billed with A81.82
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert A81.82 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| A81.82 | 04671 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A81.82
Other codes in section A80-A89 (Viral and prion infections of the central nervous system).
ICD-10 A81.82, Billing FAQ
Is ICD-10 code A81.82 billable? +
Yes, A81.82 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to A81.82? +
ICD-10 A81.82 includes: GSS syndrome.
Does A81.82 affect Medicare Advantage HCC risk adjustment? +
Yes. A81.82 maps to CMS-HCC v28 category 52. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is A81.82 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 ICD-9 codes does A81.82 map to? +
Per CMS GEMs, A81.82 maps to ICD-9 codes: 04671. 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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