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

ICD-10 G96.0

Non-Billable Header

Cerebrospinal fluid leak

G96
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM G96.0

ICD-10-CM code G96.0 represents Cerebrospinal fluid leak. This is a non-billable header code in the Nervous System chapter (block G96). The 2026 edition of ICD-10-CM G96.0 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.

Type 1 Excludes

Pure excludes, these codes can never be coded together with G96.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • cerebrospinal fluid leak from spinal puncture (G97.0)

Coding Notes

Code Also

  • if applicable:
  • intracranial hypotension (G96.81-)

Medicare LCD Coverage for G96.0

Local Coverage Determinations (LCDs) from CMS MACs that list G96.0 as a covered diagnosis.

No Medicare LCDs reference G96.0 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G96.0.

No commercial payer policies reference G96.0 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G96.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with G96.0

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

No procedure linkages on file for G96.0

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.

Convert G96.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
G96.0 34981 10000
G96.0 38861 10000

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

ICD-10 G96.0, Billing FAQ

Is ICD-10 code G96.0 billable? +

No, G96.0 is a non-billable header code. Use a more specific child code from block G96 when submitting claims.

What codes are Type 1 Excludes for G96.0? +

Type 1 Excludes (never code together with G96.0): cerebrospinal fluid leak from spinal puncture (G97.0)

What ICD-9 codes does G96.0 map to? +

Per CMS GEMs, G96.0 maps to ICD-9 codes: 34981, 38861. 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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