A52.04 ICD-10-CM Code: Syphilitic cerebral arteritis
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Infections with a predominantly sexual mode of transmission (A50-A64)
A52.04
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSyphilitic cerebral arteritis
This is an infection of the brain's blood vessels caused by syphilis, which can lead to inflammation and potentially restrict blood flow to the brain. It's a serious complication that occurs when untreated syphilis spreads to the nervous system.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A52.04 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A52.04 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A52.04 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A52.04 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A52.04 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A52.04 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A52.04 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is A52.04 an HCC code?
No. A52.04 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A52.04 is the ICD-10-CM diagnosis code for syphilitic cerebral arteritis. This is an infection of the brain's blood vessels caused by syphilis, which can lead to inflammation and potentially restrict blood flow to the brain. It's a serious complication that occurs when untreated syphilis spreads to the nervous system. A52.04 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering infections with a predominantly sexual mode of transmission (a50-a64).
A52.04 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This code is part of the neurosyphilis category and should only be used when syphilis has specifically affected cerebral arteries; verify documentation confirms arteritis rather than other forms of neurosyphilis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A52.04 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is part of the neurosyphilis category and should only be used when syphilis has specifically affected cerebral arteries; verify documentation confirms arteritis rather than other forms of neurosyphilis
- •Ensure the underlying syphilis diagnosis is also coded separately (typically A50-A53 range depending on stage) as this code represents a specific manifestation of systemic syphilis