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 guidanceAtypical 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
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A81 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A81 in this effective period.
Related Child Codes
Includes
Official- diseases of the central nervous system caused by prions
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A81 in this effective period.
Code First
OfficialICD-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
OfficialICD-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
- 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-)

