ICD-10 G06.1
Billable / Specific MCCIntraspinal abscess and granuloma
About ICD-10-CM G06.1
ICD-10-CM code G06.1 represents Intraspinal abscess and granuloma. This is a billable/specific code in the Nervous System chapter (block G06). The 2026 edition of ICD-10-CM G06.1 became effective on October 1, 2025.
Coding Tips for G06.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
G06.1 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 G06.1. Per CMS ICD-10-CM Tabular 2026.
- Abscess (embolic) of spinal cord [any part]
- Intraspinal epidural abscess or granuloma
- Intraspinal extradural abscess or granuloma
- Intraspinal subdural abscess or granuloma
Type 1 Excludes
Pure excludes, these codes can never be coded together with G06.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- tuberculous intraspinal abscess and granuloma (A17.81)
Inpatient DRG Impact, MCC
codes Intraspinal abscess and granuloma. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for G06.1
Local Coverage Determinations (LCDs) from CMS MACs that list G06.1 as a covered diagnosis.
Showing top 10 of 219 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G06.1.
1 Aetna
2 Cigna
5 Medicare
CPT Codes Commonly Billed with G06.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 95926 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95925 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95938 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95927 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 22600 CMS LCD: Billing and Coding: Cervical Fusion CMS LCD
- 22548 CMS LCD: Billing and Coding: Cervical Fusion CMS LCD
- 22590 CMS LCD: Billing and Coding: Cervical Fusion CMS LCD
- 22551 CMS LCD: Billing and Coding: Cervical Fusion CMS LCD
- 22595 CMS LCD: Billing and Coding: Cervical Fusion CMS LCD
- 22554 CMS LCD: Billing and Coding: Cervical Fusion CMS LCD
Convert G06.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| G06.1 | 3241 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To G06.1
Other codes in section G00-G09 (Inflammatory diseases of the central nervous system).
ICD-10 G06.1, Billing FAQ
Is ICD-10 code G06.1 billable? +
Yes, G06.1 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 G06.1? +
ICD-10 G06.1 includes: Abscess (embolic) of spinal cord [any part]; Intraspinal epidural abscess or granuloma; Intraspinal extradural abscess or granuloma, and 1 more clinical synonyms.
What codes are Type 1 Excludes for G06.1? +
Type 1 Excludes (never code together with G06.1): tuberculous intraspinal abscess and granuloma (A17.81)
Is G06.1 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 G06.1? +
Procedures frequently paired with G06.1 include: 95926, 95925, 95938, 95927, 22600.
What ICD-9 codes does G06.1 map to? +
Per CMS GEMs, G06.1 maps to ICD-9 codes: 3241. 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.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
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