A81.81 ICD-10-CM Code: Kuru
A81.81 maps to CMS-HCC V28 127. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. 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)
A81.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceKuru
Kuru is a rare, fatal brain disease that spreads through infected tissue, historically found in Papua New Guinea where it was transmitted through ritualistic cannibalism practices. It causes progressive neurological deterioration including tremors, emotional instability, and loss of coordination, ultimately leading to death.
Buddy Insight
Kuru is a historically significant prion disease that was endemic in the Fore people of Papua New Guinea, transmitted through ritualistic endocannibalism.
CMS-HCC V28
MappedHCC 127
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 52
Code-level coefficient reference
RXHCC
MappedHCC 112
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for A81.81. Check the code and parent instructions in the Code Book.
Excludes 2
Official- carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99
- infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99
- influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99
Related Codes
Includes
Official- diseases generally recognized as communicable or transmissibleInherited from A00-B99, A81
- diseases of the central nervous system caused by prionsInherited from A00-B99, A81
Excludes 1
Official- certain localized infections - see body system-related chaptersInherited from A00-B99, A80-A89
- postpolio syndrome (G14)Inherited from A00-B99, A80-A89
- sequelae of poliomyelitis (B91)Inherited from A00-B99, A80-A89
- sequelae of viral encephalitis (B94.1)Inherited from A00-B99, A80-A89
Code First
OfficialNo Code First sequencing instructions are included in this display for A81.81. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99, A81
- code, if applicable, to identify:Inherited from A00-B99, A81
- dementia with anxiety (F02.84, F02.A4, F02.B4, F02.C4)Inherited from A00-B99, A81
- dementia with behavioral disturbance (F02.81-, F02.A1-, F02.B1-, F02.C1-)Inherited from A00-B99, A81
- dementia with mood disturbance (F02.83, F02.A3, F02.B3, F02.C3)Inherited from A00-B99, A81
- dementia with psychotic disturbance (F02.82, F02.A2, F02.B2, F02.C2)Inherited from A00-B99, A81
- dementia without behavioral disturbance (F02.80, F02.A0, F02.B0, F02.C0)Inherited from A00-B99, A81
- mild neurocognitive disorder due to known physiological condition (F06.7-)Inherited from A00-B99, A81
Code Also
OfficialNo Code Also instructions are included in this display for A81.81. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 →
Is A81.81 an HCC code?
Yes. A81.81 (Kuru) maps to HCC 127, Dementia, Mild or Unspecified under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.341. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: A81.81 is billable and maps to V28 HCC 127, Dementia, Mild or Unspecified. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- A81.81
- Description
- Kuru
- HCC (V28)
- HCC 127 — Dementia, Mild or Unspecified
- RAF reference coefficient
- 0.341
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work A81.81 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for A81.81
For A81.81, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
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What This Code Means
A81.81 is the ICD-10-CM diagnosis code for kuru. Kuru is a rare, fatal brain disease that spreads through infected tissue, historically found in Papua New Guinea where it was transmitted through ritualistic cannibalism practices. It causes progressive neurological deterioration including tremors, emotional instability, and loss of coordination, ultimately leading to death. A81.81 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).
Under the CMS-HCC V28 risk adjustment model, A81.81 maps to Dementia, Mild or Unspecified (HCC 127) with a source-labeled community, non-dual, aged reference coefficient of 0.341. No V24 mapping is shown for A81.81; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Kuru is a prion disease and should be coded as A81.81 specifically; do not confuse with other transmissible spongiform encephalopathies like Creutzfeldt-Jakob disease (A81.0). For A81.81, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A81.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Kuru is a prion disease and should be coded as A81.81 specifically; do not confuse with other transmissible spongiform encephalopathies like Creutzfeldt-Jakob disease (A81.0)
- •This is a reportable disease in most jurisdictions; verify local public health reporting requirements and ensure proper documentation of disease progression and clinical manifestations
Clinical Significance
Kuru is a historically significant prion disease that was endemic in the Fore people of Papua New Guinea, transmitted through ritualistic endocannibalism. It is now virtually extinct due to cessation of the practice, but the code exists for historical cases and potential new cases with extremely long incubation periods (up to 50+ years).
Documentation Requirements
- ✓Confirmed or strongly suspected kuru diagnosis with epidemiological link to Papua New Guinea Fore tribe
- ✓Clinical presentation: progressive cerebellar ataxia, tremors, emotional lability (pathological laughter)
- ✓Exclusion of other prion diseases through clinical and epidemiological assessment
- ✓Stage documented: ambulatory, sedentary, or terminal
- ✓Epidemiological history documenting potential exposure
Commonly Confused Codes
- •A81.00 (Creutzfeldt-Jakob disease, unspecified): CJD is the most common prion disease but has different clinical features and transmission; kuru primarily presents with cerebellar symptoms rather than dementia
- •A81.82 (Gerstmann-Straussler-Scheinker syndrome): GSS also has prominent cerebellar ataxia but is a genetic prion disease, not acquired through exposure
- •G11.9 (Hereditary ataxia, unspecified): Genetic ataxia without the prion disease pathology