ICD-10 G35.B2
Billable / Specific HCC v28: 77Non-active primary progressive multiple sclerosis
About ICD-10-CM G35.B2
ICD-10-CM code G35.B2 represents Non-active primary progressive multiple sclerosis. This is a billable/specific code in the Nervous System chapter (block G35). The 2026 edition of ICD-10-CM G35.B2 became effective on October 1, 2025.
Coding Tips for G35.B2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
G35.B2 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under G35.B2. Per CMS ICD-10-CM Tabular 2026.
- Primary progressive multiple sclerosis without evidence of inflammatory disease activity
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.B2
Local Coverage Determinations (LCDs) from CMS MACs that list G35.B2 as a covered diagnosis.
Showing top 10 of 948 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G35.B2.
5 Medicare
CPT Codes Commonly Billed with G35.B2
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 31570 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 31573 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- J9190 CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions CMS LCD
- J9260 CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions CMS LCD
- J9215 CMS LCD: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions CMS LCD
- J1553 CMS LCD: Billing and Coding: Immune Globulin Intravenous (IVIg) CMS LCD
- 91125 CMS LCD: Billing and Coding: Pelvic Floor Dysfunction: Anorectal Manometry and EMG CMS LCD
Codes Adjacent To G35.B2
Other codes in section G35-G37 (Demyelinating diseases of the central nervous system).
ICD-10 G35.B2, Billing FAQ
Is ICD-10 code G35.B2 billable? +
Yes, G35.B2 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 G35.B2? +
ICD-10 G35.B2 includes: Primary progressive multiple sclerosis without evidence of inflammatory disease activity.
Does G35.B2 affect Medicare Advantage HCC risk adjustment? +
Yes. G35.B2 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.B2? +
Procedures frequently paired with G35.B2 include: 31570, 31573, J9190, J9260, J9215.
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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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