B02.24

Billable

Postherpetic myelitis

HCC Category Mapping

V28HCC 182 — Spinal Cord Disorders/Injuries

0.282

V24HCC 72 — Spinal Cord Disorders/Injuries

0.464

ESRDHCC 72 — Spinal Cord Disorders/Injuries

0.000

RxHCCHCC 155 — Myelitis and Encephalomyelitis

0.000

What This Code Means

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

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

Code Hierarchy

└B02Zoster [herpes zoster]└B02.2Zoster with other nervous system involvement └B02.24Postherpetic myelitis

└B02.24Postherpetic myelitis