B02.24
BillablePostherpetic myelitis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is B02.24 an HCC code?
Yes. B02.24 maps to Spinal Cord Disorders/Injuries under the CMS-HCC V28 risk adjustment model (and Spinal Cord Disorders/Injuries under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for B02.24
For B02.24 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed B02.24 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
B02.24 is the ICD-10-CM diagnosis code for postherpetic myelitis. Inflammation of the spinal cord occurring as a complication after a shingles infection. B02.24 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).
Under the CMS-HCC V28 risk adjustment model, B02.24 maps to Spinal Cord Disorders/Injuries (HCC 182) with a community, non-dual, aged base RAF weight of 0.282. Under the older V24 model, B02.24 mapped to the same category but with a base RAF weight of 0.464 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
This is a serious neurological complication requiring careful documentation of motor and sensory deficits. Because B02.24 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for B02.24 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a serious neurological complication requiring careful documentation of motor and sensory deficits
- •Distinguish from other spinal cord conditions by confirming the temporal relationship to shingles
Clinical Significance
Postherpetic myelitis is a rare but devastating complication where herpes zoster virus damages the spinal cord, potentially causing paralysis, sensory loss, and autonomic dysfunction. It represents the most severe neurological sequela of shingles and carries significant implications for long-term disability and resource utilization.
Documentation Requirements
- ✓Documented prior herpes zoster episode with temporal relationship to myelitis onset
- ✓MRI of the spine confirming myelitis (T2 hyperintensity within the spinal cord)
- ✓CSF analysis showing VZV PCR positivity or intrathecal VZV antibody production
- ✓Spinal cord level documented (cervical, thoracic, lumbar) with neurological examination
- ✓Motor and sensory deficits with functional status assessment