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

ICD-10 G05

Non-Billable Header

Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

G05
Block
0
Synonyms
0
LCDs
0
Payer Policies
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Linked CPTs

About ICD-10-CM G05

ICD-10-CM code G05 represents Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere. This is a non-billable header code in the Nervous System chapter (block G05). The 2026 edition of ICD-10-CM G05 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with G05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • adenoviral encephalitis, myelitis and encephalomyelitis (A85.1)
  • encephalitis, myelitis and encephalomyelitis (in) measles (B05.0)
  • enteroviral encephalitis, myelitis and encephalomyelitis (A85.0)
  • herpesviral [herpes simplex] encephalitis, myelitis and encephalomyelitis (B00.4)
  • listerial encephalitis, myelitis and encephalomyelitis (A32.12)
  • meningococcal encephalitis, myelitis and encephalomyelitis (A39.81)
  • mumps encephalitis, myelitis and encephalomyelitis (B26.2)
  • postchickenpox encephalitis, myelitis and encephalomyelitis (B01.1-)
  • rubella encephalitis, myelitis and encephalomyelitis (B06.01)
  • toxoplasmosis encephalitis, myelitis and encephalomyelitis (B58.2)
  • zoster encephalitis, myelitis and encephalomyelitis (B02.0)

Coding Notes

Code First

  • underlying disease, such as:
  • congenital toxoplasmosis encephalitis, myelitis and encephalomyelitis (P37.1)
  • cytomegaloviral encephalitis, myelitis and encephalomyelitis (B25.8)
  • encephalitis, myelitis and encephalomyelitis (in) systemic lupus erythematosus (M32.19)
  • eosinophilic meningoencephalitis (B83.2)
  • human immunodeficiency virus [HIV] disease (B20)
  • poliovirus (A80.-)
  • suppurative otitis media (H66.01-H66.4)
  • systemic lupus erythematosus (M32.19)
  • trichinellosis (B75)

Medicare LCD Coverage for G05

Local Coverage Determinations (LCDs) from CMS MACs that list G05 as a covered diagnosis.

No Medicare LCDs reference G05 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G05.

No commercial payer policies reference G05 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with G05

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

No procedure linkages on file for G05

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 G05, Billing FAQ

Is ICD-10 code G05 billable? +

No, G05 is a non-billable header code. Use a more specific child code from block G05 when submitting claims.

What codes are Type 1 Excludes for G05? +

Type 1 Excludes (never code together with G05): adenoviral encephalitis, myelitis and encephalomyelitis (A85.1); encephalitis, myelitis and encephalomyelitis (in) measles (B05.0); enteroviral encephalitis, myelitis and encephalomyelitis (A85.0)

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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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