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

ICD-10 B05.0

Billable / Specific MCC

Measles complicated by encephalitis

B05
Block
1
Synonyms
62
LCDs
4
Payer Policies
16
Linked CPTs

About ICD-10-CM B05.0

ICD-10-CM code B05.0 represents Measles complicated by encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B05). The 2026 edition of ICD-10-CM B05.0 became effective on October 1, 2025.

Coding Tips for B05.0

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

Inpatient DRG impact: MCC

B05.0 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under B05.0. Per CMS ICD-10-CM Tabular 2026.

  • Postmeasles encephalitis

Inpatient DRG Impact, MCC

codes Measles complicated by 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 B05.0

Local Coverage Determinations (LCDs) from CMS MACs that list B05.0 as a covered diagnosis.

62 LCDs

Showing top 10 of 62 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95719 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95812 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95708 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95705 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95700 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95822 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95717 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95813 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95816 →
CMS LCD: Billing and Coding: Special Electroencephalography
Article ID: 56771, Effective: 2024-11-01 00:00:00, 289 covered, 0 non-covered
CPT 95819 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B05.0.

4 policies

4 Medicare

Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Special Electroencephalography
Policy ID: ART-56771
Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
Policy ID: ART-56773
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with B05.0

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

16 linkages
  • 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
  • 95930 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
  • 92652 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
  • 95939 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
  • 95708 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95721 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95719 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD

Convert B05.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
B05.0 0550 00000

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

ICD-10 B05.0, Billing FAQ

Is ICD-10 code B05.0 billable? +

Yes, B05.0 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 B05.0? +

ICD-10 B05.0 includes: Postmeasles encephalitis.

Is B05.0 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 B05.0? +

Procedures frequently paired with B05.0 include: 95929, 92651, 92653, 95928, 95930.

What ICD-9 codes does B05.0 map to? +

Per CMS GEMs, B05.0 maps to ICD-9 codes: 0550. 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 June 2, 2026.

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