A87.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupA87.1

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

A87.1

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Adenoviral meningitis

This is a viral infection of the protective membranes surrounding the brain and spinal cord caused by adenovirus. It causes symptoms like fever, headache, and neck stiffness.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 004

HHS-HCC 004 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

A87Viral meningitis A87.1Adenoviral meningitis

Inclusion Terms

Official

No inclusion terms are included in this display for A87.1. 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

Official

A87.0Enteroviral meningitis A87.2Lymphocytic choriomeningitis A87.8Other viral meningitis A87.9Viral meningitis, unspecified

Includes

Official

diseases generally recognized as communicable or transmissibleInherited from A00-B99

Excludes 1

Official

certain localized infections - see body system-related chaptersInherited from A00-B99, A80-A89, A87
postpolio syndrome (G14)Inherited from A00-B99, A80-A89, A87
sequelae of poliomyelitis (B91)Inherited from A00-B99, A80-A89, A87
sequelae of viral encephalitis (B94.1)Inherited from A00-B99, A80-A89, A87
meningitis due to herpesvirus [herpes simplex] (B00.3)Inherited from A00-B99, A80-A89, A87
meningitis due to measles virus (B05.1)Inherited from A00-B99, A80-A89, A87
meningitis due to mumps virus (B26.1)Inherited from A00-B99, A80-A89, A87
meningitis due to poliomyelitis virus (A80.-)Inherited from A00-B99, A80-A89, A87
meningitis due to zoster (B02.1)Inherited from A00-B99, A80-A89, A87

Code First

Official

No Code First sequencing instructions are included in this display for A87.1. 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

Code Also

Official

No Code Also instructions are included in this display for A87.1. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify the causative organism is confirmed as adenovirus before coding A87.1; other viral meningitis codes (A87.0, A87.2, etc.) apply to different viral causes

This code should be used only for meningitis cases; if the adenoviral infection affects other sites (respiratory, conjunctivitis), use the appropriate adenoviral infection code instead

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 A87.1 an HCC code?

Code: A87.1
Description: Adenoviral meningitis
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

A87.1 is the ICD-10-CM diagnosis code for adenoviral meningitis. This is a viral infection of the protective membranes surrounding the brain and spinal cord caused by adenovirus. It causes symptoms like fever, headache, and neck stiffness. A87.1 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).

A87.1 has no mapping under the current CMS-HCC V28 community payment model. A87.1 also appears in the HHS-HCC commercial risk model (HCC 004 (HHS-HCC 004 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Verify the causative organism is confirmed as adenovirus before coding A87.1; other viral meningitis codes (A87.0, A87.2, etc.) apply to different viral causes.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A87.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the causative organism is confirmed as adenovirus before coding A87.1; other viral meningitis codes (A87.0, A87.2, etc.) apply to different viral causes
•This code should be used only for meningitis cases; if the adenoviral infection affects other sites (respiratory, conjunctivitis), use the appropriate adenoviral infection code instead