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

ICD-10 B10.01

Billable / Specific MCC

Human herpesvirus 6 encephalitis

B10
Block
0
Synonyms
576
LCDs
6
Payer Policies
9
Linked CPTs

About ICD-10-CM B10.01

ICD-10-CM code B10.01 represents Human herpesvirus 6 encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B10). The 2026 edition of ICD-10-CM B10.01 became effective on October 1, 2025.

Coding Tips for B10.01

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

Inpatient DRG impact: MCC

B10.01 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.

Inpatient DRG Impact, MCC

codes Human herpesvirus 6 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 B10.01

Local Coverage Determinations (LCDs) from CMS MACs that list B10.01 as a covered diagnosis.

576 LCDs

Showing top 10 of 576 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87555 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87653 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87486 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87626 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 0109U →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87516 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87517 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87528 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87476 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87594 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B10.01.

6 policies

5 Medicare

Billing and Coding: Special Electroencephalography
Policy ID: ART-56771
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58710
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58720
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58747

CPT Codes Commonly Billed with B10.01

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

9 linkages
  • 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
  • 95813 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95822 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95717 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95812 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95700 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD
  • 95705 CMS LCD: Billing and Coding: Special Electroencephalography CMS LCD

Convert B10.01 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
B10.01 05821 00000

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

ICD-10 B10.01, Billing FAQ

Is ICD-10 code B10.01 billable? +

Yes, B10.01 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is B10.01 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 B10.01? +

Procedures frequently paired with B10.01 include: 95708, 95721, 95719, 95813, 95822.

What ICD-9 codes does B10.01 map to? +

Per CMS GEMs, B10.01 maps to ICD-9 codes: 05821. 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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