A85.2 ICD-10-CM Code: Arthropod-borne viral encephalitis, unspecified
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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)
A85.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceArthropod-borne viral encephalitis, unspecified
This code describes inflammation of the brain caused by a virus transmitted through insect bites (such as mosquitoes or ticks), when the specific type of virus has not been identified. It represents a serious infection affecting brain tissue that requires medical attention.
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 A85.2 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A85.2 in this effective period.
Related Child Codes
Includes
Official- specified viral encephalomyelitis NEC
- specified viral meningoencephalitis NEC
Excludes 1
Official- West nile virus with encephalitis (A92.31)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A85.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A85.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A85.2 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 A85.2 an HCC code?
No. A85.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A85.2 is the ICD-10-CM diagnosis code for arthropod-borne viral encephalitis, unspecified. This code describes inflammation of the brain caused by a virus transmitted through insect bites (such as mosquitoes or ticks), when the specific type of virus has not been identified. It represents a serious infection affecting brain tissue that requires medical attention. A85.2 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).
A85.2 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.
Use this code only when the specific arthropod-borne virus (such as West Nile virus, dengue, or Zika) cannot be determined; if the specific virus is identified, use a more specific A85 subcategory code instead.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A85.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the specific arthropod-borne virus (such as West Nile virus, dengue, or Zika) cannot be determined; if the specific virus is identified, use a more specific A85 subcategory code instead
- •Ensure documentation supports encephalitis (brain inflammation) rather than meningitis or other viral infections; review provider notes for clinical findings such as fever, headache, altered mental status, or neurological symptoms
Excludes 1, Do NOT code together
- West nile virus with encephalitis (A92.31)