A81
Non-Billable (Header)Atypical virus infections of central nervous system
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
What This Code Means
A81 is the ICD-10-CM diagnosis code for atypical virus infections of central nervous system. A81 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering viral and prion infections of the central nervous system (a80-a89).
Header codes like A81 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at A81's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Includes
- diseases of the central nervous system caused by prions
Use Additional Code
- code, if applicable, to identify:
- dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)
- dementia with behavioral disturbance (F02.81-, F02.A1-, F02.B1-, F02.C1-)
- dementia with mood disturbance (F02.83, F02.A3, F02.B3, F02.C3)
- dementia with psychotic disturbance (F02.82, F02.A2, F02.B2, F02.C2)
- dementia without behavioral disturbance (F02.80, F02.A0, F02.B0, F02.C0)
- mild neurocognitive disorder due to known physiological condition (F06.7-)