ICD-10 G92.8
Billable / Specific MCCOther toxic encephalopathy
About ICD-10-CM G92.8
ICD-10-CM code G92.8 represents Other toxic encephalopathy. This is a billable/specific code in the Nervous System chapter (block G92). The 2026 edition of ICD-10-CM G92.8 became effective on October 1, 2025.
Coding Tips for G92.8
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
G92.8 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 G92.8. Per CMS ICD-10-CM Tabular 2026.
- Toxic encephalitis
- Toxic metabolic encephalopathy
Use Additional Code
When coding G92.8, also report these additional codes when applicable.
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Coding Notes
Code First
- poisoning due to drug or toxin, if applicable, (T36-T65 with fifth or sixth character 1-4)
Inpatient DRG Impact, MCC
codes Other toxic encephalopathy. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for G92.8
Local Coverage Determinations (LCDs) from CMS MACs that list G92.8 as a covered diagnosis.
Showing top 10 of 49 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G92.8.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with G92.8
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To G92.8
Other codes in section G89-G99 (Other disorders of the nervous system).
ICD-10 G92.8, Billing FAQ
Is ICD-10 code G92.8 billable? +
Yes, G92.8 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 G92.8? +
ICD-10 G92.8 includes: Toxic encephalitis; Toxic metabolic encephalopathy.
Is G92.8 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.
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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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