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

ICD-10 G97.49

Billable / Specific CC

Accidental puncture and laceration of other nervous system organ or structure during other procedure

G97
Block
0
Synonyms
82
LCDs
8
Payer Policies
8
Linked CPTs

About ICD-10-CM G97.49

ICD-10-CM code G97.49 represents Accidental puncture and laceration of other nervous system organ or structure during other procedure. This is a billable/specific code in the Nervous System chapter (block G97). The 2026 edition of ICD-10-CM G97.49 became effective on October 1, 2025.

Coding Tips for G97.49

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

Inpatient DRG impact: CC

G97.49 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 Accidental puncture and laceration of other nervous system organ or structure during other procedure. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for G97.49

Local Coverage Determinations (LCDs) from CMS MACs that list G97.49 as a covered diagnosis.

82 LCDs

Showing top 10 of 82 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Non-Invasive Vascular Studies
Article ID: 56697, Effective: 2025-11-06 00:00:00, 1440 covered, 0 non-covered
CPT 93924 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G97.49.

8 policies

1 Cigna

Intraoperative Monitoring - (0509)
Policy ID: MM_0509

5 Medicare

Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
Policy ID: ART-52992
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Non-Invasive Vascular Studies
Policy ID: ART-56697
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204
Billing and Coding: Non-Invasive Cerebrovascular Studies
Policy ID: ART-57592

1 Aetna

Cardiovascular Disease Risk Tests
Policy ID: CPB-0381

CPT Codes Commonly Billed with G97.49

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

8 linkages
  • 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
  • 93882 CMS LCD: Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies CMS LCD

Convert G97.49 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
G97.49 9982 10000

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

ICD-10 G97.49, Billing FAQ

Is ICD-10 code G97.49 billable? +

Yes, G97.49 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is G97.49 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 G97.49? +

Procedures frequently paired with G97.49 include: 93892, 93888, 93893, 93886, 93897.

What ICD-9 codes does G97.49 map to? +

Per CMS GEMs, G97.49 maps to ICD-9 codes: 9982. 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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