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A81 ICD-10-CM Code: Atypical virus infections of central nervous system

A81 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Viral and prion infections of the central nervous system (A80-A89)

A81

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Atypical virus infections of central nervous system

Atypical virus infections of central nervous system

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
A8Viral and prion infections of the central nervous system (A80-A89)
A81Atypical virus infections of central nervous system

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for A81 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for A81 in this effective period.

Related Child Codes

Official
A81.0Creutzfeldt-Jakob disease
A81.1Subacute sclerosing panencephalitis
A81.2Progressive multifocal leukoencephalopathy
A81.8Other atypical virus infections of central nervous system
A81.9Atypical virus infection of central nervous system, unspecified

Includes

Official
  • diseases of the central nervous system caused by prions

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for A81 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for A81 in this effective period.

Use Additional

Official
  • 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)

Code Also

Official

ICD-10-CM does not list Code Also instructions for A81 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
A81
Description
Atypical virus infections of central nervous system
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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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

Child Codes

Code Hierarchy

A81Atypical virus infections of central nervous system
A81Atypical virus infections of central nervous system

More on A81

Referenced in blog posts

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