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

ICD-10 B94.1

Billable / Specific

Sequelae of viral encephalitis

B94
Block
0
Synonyms
51
LCDs
4
Payer Policies
9
Linked CPTs

About ICD-10-CM B94.1

ICD-10-CM code B94.1 represents Sequelae of viral encephalitis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B94). The 2026 edition of ICD-10-CM B94.1 became effective on October 1, 2025.

Medicare LCD Coverage for B94.1

Local Coverage Determinations (LCDs) from CMS MACs that list B94.1 as a covered diagnosis.

51 LCDs

Showing top 10 of 51 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 B94.1.

4 policies

1 Cigna

Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

3 Medicare

Billing and Coding: CT of the Head
Policy ID: ART-56612
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 B94.1

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 B94.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
B94.1 1390 00000

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

ICD-10 B94.1, Billing FAQ

Is ICD-10 code B94.1 billable? +

Yes, B94.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with B94.1? +

Procedures frequently paired with B94.1 include: 95708, 95721, 95719, 95813, 95822.

What ICD-9 codes does B94.1 map to? +

Per CMS GEMs, B94.1 maps to ICD-9 codes: 1390. 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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