ICD-10 G35
Non-Billable Header HCC v28: 77Multiple sclerosis
About ICD-10-CM G35
ICD-10-CM code G35 represents Multiple sclerosis. This is a non-billable header code in the Nervous System chapter (block G35). The 2026 edition of ICD-10-CM G35 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.
Coding Tips for G35
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
G35 is a CMS-HCC v28 risk-adjustment code (category 77). 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.
Medicare Advantage HCC Impact
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 G35
Local Coverage Determinations (LCDs) from CMS MACs that list G35 as a covered diagnosis.
Showing top 10 of 27 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G35.
3 Medicare
CPT Codes Commonly Billed with G35
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 99205 New patient office visit — complex/high-risk: uncontrolled diabetes, heart failure, COPD exacerbation, cancer, MS, RA, CKD, CAD, recurrent depression, epilepsy, lupus, syncope, cognitive decline Primary Care
- 99215 Established patient — high complexity: HF exacerbation, COPD exacerbation, cancer management, MS, advanced CKD, uncontrolled diabetes, recurrent syncope, respiratory failure, liver cirrhosis Primary Care
- 70553 MRI brain with and without contrast — migraine, headache, encephalopathy, brain cancer, epilepsy, brain neoplasm, cognitive decline, MS, hydrocephalus, aphasia, numbness Radiology
- 70551 MRI brain without contrast — migraine, headache, encephalopathy, cognitive decline, MS, epilepsy, syncope, dizziness Radiology
- 97112 Neuromuscular reeducation — hemiplegia, paraplegia, cerebral palsy, post-stroke, gait abnormality, ataxia, MS, Parkinson, concussion, hx TBI Physical Therapy
- 97530 Therapeutic activities — post knee/hip replacement, post fracture, hemiplegia, post-stroke, MS — functional tasks Physical Therapy
- 97163 PT evaluation high complexity — hemiplegia, paraplegia, post-stroke, MS, Parkinson, TBI, fracture, post-replacement Physical Therapy
- 95886 EMG each extremity — carpal tunnel, sciatica, neuropathy, radiculopathy, muscular dystrophy, ALS, MS, diabetic neuropathy, hereditary neuropathy, myalgia Neurology
Convert G35 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 |
|---|---|---|
| G35 | 340 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To G35
Other codes in section G35-G37 (Demyelinating diseases of the central nervous system).
ICD-10 G35, Billing FAQ
Is ICD-10 code G35 billable? +
No, G35 is a non-billable header code. Use a more specific child code from block G35 when submitting claims.
Does G35 affect Medicare Advantage HCC risk adjustment? +
Yes. G35 maps to CMS-HCC v28 category 77. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with G35? +
Procedures frequently paired with G35 include: 99205, 99215, 70553, 70551, 97112.
What ICD-9 codes does G35 map to? +
Per CMS GEMs, G35 maps to ICD-9 codes: 340. 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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