What is ICD-10 code B02.24?

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. It belongs to the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99). B02.24 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. B02.24 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. B02.24 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. B02.24 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does B02.24 map to under V28?

B02.24 maps to CMS-HCC V28 182 (Spinal Cord Disorders/Injuries). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does B02.24 pay in RAF?

B02.24 carries a community, non-dual, aged (CNA) RAF weight of 0.478 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for B02.24?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For B02.24, V28 maps to Spinal Cord Disorders/Injuries at RAF 0.478 while V24 mapped to Spinal Cord Disorders/Injuries at RAF 0.481. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports B02.24?

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 Because B02.24 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM B02.24: Postherpetic myelitis

B02.24 maps to CMS-HCC V28 182 (RAF 0.478). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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Code lookupB02.24Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Viral infections characterized by skin and mucous membrane lesions (B00-B09)

B02.24

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

Postherpetic myelitis

Inflammation of the spinal cord occurring as a complication after a shingles infection.

Buddy Insight

Postherpetic myelitis is a rare but devastating complication where herpes zoster virus damages the spinal cord, potentially causing paralysis, sensory loss, and autonomic dysfunction.

CMS-HCC V28

Mapped

HCC 182

Spinal Cord Disorders/Injuries

RAF 0.478

CMS-HCC V24

Mapped

HCC 72

Spinal Cord Disorders/Injuries

RAF 0.481

ACA/HHS

Mapped

HCC 110

HHS-HCC 110

Varies by metal level

ESRD/PACE

Mapped

HCC 72

Spinal Cord Disorders/Injuries

RAF 0.099

RXHCC

Mapped

HCC 155

Myelitis and Encephalomyelitis

RAF 0.086

Code Book Path

Official

B02Zoster [herpes zoster]

B02.2Zoster with other nervous system involvement

B02.24Postherpetic myelitis

Inclusion Terms

Official

Herpes zoster myelitis

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for B02.24 in this effective period.

Related Child Codes

Official

B02.21Postherpetic geniculate ganglionitis

B02.22Postherpetic trigeminal neuralgia

B02.23Postherpetic polyneuropathy

B02.29Other postherpetic nervous system involvement

Includes

Official

ICD-10-CM does not list Includes notes for B02.24 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for B02.24 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for B02.24 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for B02.24 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for B02.24 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

MEAT Support

HCC Buddy guidance

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

Audit Caution

HCC Buddy guidance

Using generic myelitis codes (G04.89) when VZV etiology is confirmed as postherpetic

Confusing primary varicella myelitis (B01.12) with postherpetic myelitis (B02.24) — primary vs. reactivation distinction is critical

Not documenting the causal link between the prior herpes zoster episode and the subsequent myelitis

Missing the functional impact documentation (paralysis level, bowel/bladder function) needed for severity capture

Common Mistakes

HCC Buddy guidance

B00.82 (Herpes simplex myelitis) — HSV myelitis is caused by herpes simplex virus, not VZV; different virus despite similar presentation

B01.12 (Varicella myelitis) — Myelitis during primary varicella infection; B02.24 occurs after herpes zoster (VZV reactivation)

G37.3 (Acute transverse myelitis in demyelinating disease of CNS) — Autoimmune myelitis; B02.24 is infectious and requires VZV confirmation

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 B02.24 an HCC code?

Yes. B02.24 (Postherpetic myelitis) maps to Spinal Cord Disorders/Injuries under the CMS-HCC V28 risk adjustment model (and Spinal Cord Disorders/Injuries under V24), with a community non-dual aged RAF of 0.478. It is billable for payment year 2026.

Coder answer: B02.24 is billable and maps to V28 HCC 182, Spinal Cord Disorders/Injuries. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: B02.24
Description: Postherpetic myelitis
HCC (V28): HCC 182 — Spinal Cord Disorders/Injuries
RAF: 0.478
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 182, Spinal Cord Disorders/Injuries

0.478

V24HCC 72, Spinal Cord Disorders/Injuries

0.481

ESRDHCC 72, Spinal Cord Disorders/Injuries

0.099

RxHCCHCC 155, Myelitis and Encephalomyelitis

0.086

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work B02.24 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

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.

Coder workflow notes

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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 0.478. Under the older V24 model, B02.24 mapped to the same category but with a base RAF weight of 0.481, 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

Commonly Confused Codes

•B00.82 (Herpes simplex myelitis): HSV myelitis is caused by herpes simplex virus, not VZV; different virus despite similar presentation
•B01.12 (Varicella myelitis): Myelitis during primary varicella infection; B02.24 occurs after herpes zoster (VZV reactivation)
•G37.3 (Acute transverse myelitis in demyelinating disease of CNS): Autoimmune myelitis; B02.24 is infectious and requires VZV confirmation