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

ICD-10 G46.1

Billable / Specific CC

Anterior cerebral artery syndrome

G46
Block
0
Synonyms
435
LCDs
30
Payer Policies
11
Linked CPTs

About ICD-10-CM G46.1

ICD-10-CM code G46.1 represents Anterior cerebral artery syndrome. This is a billable/specific code in the Nervous System chapter (block G46). The 2026 edition of ICD-10-CM G46.1 became effective on October 1, 2025.

Coding Tips for G46.1

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

Inpatient DRG impact: CC

G46.1 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Anterior cerebral artery syndrome. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for G46.1

Local Coverage Determinations (LCDs) from CMS MACs that list G46.1 as a covered diagnosis.

435 LCDs

Showing top 10 of 435 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 G46.1.

30 policies

2 Cigna

Ambulatory External and Implantable Electrocardiographic Monitoring - (0547)
Policy ID: MM_0547
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-52868
Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
Policy ID: ART-52992
Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: Cardiac Radionuclide Imaging
Policy ID: ART-56476
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-56505

CPT Codes Commonly Billed with G46.1

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

11 linkages
  • C8925 CMS LCD: Billing and Coding: Transesophageal Echocardiography (TEE) CMS LCD
  • C8927 CMS LCD: Billing and Coding: Transesophageal Echocardiography (TEE) CMS LCD
  • C8926 CMS LCD: Billing and Coding: Transesophageal Echocardiography (TEE) CMS LCD
  • 93892 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD
  • 93888 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD
  • 93893 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD
  • 93886 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD
  • 93897 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD
  • 93896 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD
  • 93898 CMS LCD: Billing and Coding: Transcranial Doppler Studies CMS LCD

Convert G46.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
G46.1 4358 10000

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

Codes Adjacent To G46.1

Other codes in section G40-G47 (Episodic and paroxysmal disorders).

G40 Epilepsy and recurrent seizures (non-billable) G40.0 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset (non-billable) G40.00 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable (non-billable) G40.001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus G40.009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus G40.01 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable (non-billable) G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus G40.1 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures (non-billable) G40.10 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable (non-billable) G40.101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus G40.109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus G40.11 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable (non-billable) G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus G40.2 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures (non-billable) G40.20 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable (non-billable) G40.201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus G40.209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus G40.21 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable (non-billable)

ICD-10 G46.1, Billing FAQ

Is ICD-10 code G46.1 billable? +

Yes, G46.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is G46.1 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with G46.1? +

Procedures frequently paired with G46.1 include: C8925, C8927, C8926, 93892, 93888.

What ICD-9 codes does G46.1 map to? +

Per CMS GEMs, G46.1 maps to ICD-9 codes: 4358. 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 May 31, 2026.

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