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

ICD-10 B10.09

Billable / Specific MCC

Other human herpesvirus encephalitis

B10
Block
1
Synonyms
39
LCDs
2
Payer Policies
9
Linked CPTs

About ICD-10-CM B10.09

ICD-10-CM code B10.09 represents Other human herpesvirus encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B10). The 2026 edition of ICD-10-CM B10.09 became effective on October 1, 2025.

Coding Tips for B10.09

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

Inpatient DRG impact: MCC

B10.09 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 B10.09. Per CMS ICD-10-CM Tabular 2026.

  • Human herpesvirus 7 encephalitis

Inpatient DRG Impact, MCC

codes Other human herpesvirus 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 B10.09

Local Coverage Determinations (LCDs) from CMS MACs that list B10.09 as a covered diagnosis.

39 LCDs

Showing top 10 of 39 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 B10.09.

2 policies

2 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

CPT Codes Commonly Billed with B10.09

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 B10.09 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
B10.09 05829 00000

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

ICD-10 B10.09, Billing FAQ

Is ICD-10 code B10.09 billable? +

Yes, B10.09 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 B10.09? +

ICD-10 B10.09 includes: Human herpesvirus 7 encephalitis.

Is B10.09 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 B10.09? +

Procedures frequently paired with B10.09 include: 95708, 95721, 95719, 95813, 95822.

What ICD-9 codes does B10.09 map to? +

Per CMS GEMs, B10.09 maps to ICD-9 codes: 05829. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included