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

ICD-10 G31.09

Billable / Specific HCC v28: 52

Other frontotemporal neurocognitive disorder

G31
Block
1
Synonyms
318
LCDs
16
Payer Policies
27
Linked CPTs

About ICD-10-CM G31.09

ICD-10-CM code G31.09 represents Other frontotemporal neurocognitive disorder. This is a billable/specific code in the Nervous System chapter (block G31). The 2026 edition of ICD-10-CM G31.09 became effective on October 1, 2025.

Coding Tips for G31.09

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

HCC capture: document with MEAT each year

G31.09 is a CMS-HCC v28 risk-adjustment code (category 52). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under G31.09. Per CMS ICD-10-CM Tabular 2026.

  • Frontal dementia

Use Additional Code

When coding G31.09, also report these additional codes when applicable.

  • code, if applicable, to identify mild neurocognitive disorders due to known physiological condition (F06.7-)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 52
ESRD-HCC
Category 52

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for G31.09

Local Coverage Determinations (LCDs) from CMS MACs that list G31.09 as a covered diagnosis.

318 LCDs

Showing top 10 of 318 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G31.09.

16 policies

3 Cigna

Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)
Policy ID: MM_0551
Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258
Serum Folate and Red Blood Cell Folate Testing - (0567)
Policy ID: MM_0567

5 Medicare

Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions
Policy ID: ART-53134
Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Home Health - Psychiatric Care
Policy ID: ART-56756
Billing and Coding: Outpatient Speech Language Pathology
Policy ID: ART-56868

CPT Codes Commonly Billed with G31.09

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

27 linkages
  • G0252 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • 78608 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • A9597 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • A9601 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • G0235 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • 78609 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • A9552 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • G0219 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • A9598 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
  • 95857 CMS LCD: Billing and Coding: Outpatient Speech Language Pathology CMS LCD

Convert G31.09 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
G31.09 33119 00000

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

ICD-10 G31.09, Billing FAQ

Is ICD-10 code G31.09 billable? +

Yes, G31.09 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 G31.09? +

ICD-10 G31.09 includes: Frontal dementia.

Does G31.09 affect Medicare Advantage HCC risk adjustment? +

Yes. G31.09 maps to CMS-HCC v28 category 52. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with G31.09? +

Procedures frequently paired with G31.09 include: G0252, 78608, A9597, A9601, G0235.

What ICD-9 codes does G31.09 map to? +

Per CMS GEMs, G31.09 maps to ICD-9 codes: 33119. 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 June 1, 2026.

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