B01.11
BillableVaricella encephalitis and encephalomyelitis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is B01.11 an HCC code?
No. B01.11 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
B01.11 is the ICD-10-CM diagnosis code for varicella encephalitis and encephalomyelitis. Chickenpox virus infection causing inflammation of the brain and spinal cord, which can result in serious neurological complications. B01.11 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering viral infections characterized by skin and mucous membrane lesions (b00-b09).
B01.11 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.
This is a more severe complication than simple meningitis; verify encephalitis is documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B01.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a more severe complication than simple meningitis; verify encephalitis is documented
- •Document any neurological deficits or complications for complete clinical coding