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

ICD-10 B06.01

Billable / Specific MCC

Rubella encephalitis

B06
Block
1
Synonyms
67
LCDs
6
Payer Policies
16
Linked CPTs

About ICD-10-CM B06.01

ICD-10-CM code B06.01 represents Rubella encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B06). The 2026 edition of ICD-10-CM B06.01 became effective on October 1, 2025.

Coding Tips for B06.01

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

Inpatient DRG impact: MCC

B06.01 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 B06.01. Per CMS ICD-10-CM Tabular 2026.

  • Rubella meningoencephalitis

Inpatient DRG Impact, MCC

codes Rubella 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 B06.01

Local Coverage Determinations (LCDs) from CMS MACs that list B06.01 as a covered diagnosis.

67 LCDs

Showing top 10 of 67 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: 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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B06.01.

6 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: Neurophysiology Evoked Potentials (NEPs)
Policy ID: ART-56773
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

CPT Codes Commonly Billed with B06.01

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 B06.01 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
B06.01 05601 00000

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

ICD-10 B06.01, Billing FAQ

Is ICD-10 code B06.01 billable? +

Yes, B06.01 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 B06.01? +

ICD-10 B06.01 includes: Rubella meningoencephalitis.

Is B06.01 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 B06.01? +

Procedures frequently paired with B06.01 include: 95929, 92651, 92653, 95928, 95930.

What ICD-9 codes does B06.01 map to? +

Per CMS GEMs, B06.01 maps to ICD-9 codes: 05601. 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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