What is ICD-10 code D86.82?

D86.82 is the ICD-10-CM diagnosis code for Multiple cranial nerve palsies in sarcoidosis. A condition where sarcoidosis, an inflammatory disease, affects multiple nerves in the head and face, causing weakness or paralysis of facial muscles and other cranial nerve functions. D86.82 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D86.82 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. D86.82 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. D86.82 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.

What is the V28 vs V24 difference for D86.82?

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. D86.82 was a payment HCC under V24 (Myasthenia Gravis/Myoneural Conditions and Guillain-Barre Syndrome) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D86.82?

Specify which cranial nerves are affected when documentation is available This code indicates sarcoidosis with neurological complications; ensure the primary sarcoidosis diagnosis is also coded Because D86.82 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.

D86.82: Multiple cranial nerve palsies in sarcoidosis — ICD-10 | Myasthenia Gravis/Myoneural

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD86.82Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) / Certain disorders involving the immune mechanism (D80-D89)

D86.82

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

Multiple cranial nerve palsies in sarcoidosis

A condition where sarcoidosis, an inflammatory disease, affects multiple nerves in the head and face, causing weakness or paralysis of facial muscles and other cranial nerve functions.

Buddy Insight

Multiple cranial nerve palsies due to sarcoidosis represents significant neurosarcoidosis, a serious complication affecting approximately 5-10% of sarcoidosis patients.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Mapped

HCC 75

Myasthenia Gravis/Myoneural C...

RAF 0.425

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 75

Myasthenia Gravis/Myoneural C...

RAF 0.0

RXHCC

Mapped

HCC 158

Guillain-Barre Syndrome and O...

RAF 0.0

Code Trumping

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Code Book Path

Official

D86Sarcoidosis

D86.8Sarcoidosis of other sites

D86.82Multiple cranial nerve palsies in sarcoidosis

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D86.82 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D86.82 in this effective period.

Related Child Codes

Official

D86.81Sarcoid meningitis

D86.83Sarcoid iridocyclitis

D86.84Sarcoid pyelonephritis

D86.85Sarcoid myocarditis

D86.86Sarcoid arthropathy

Includes

Official

ICD-10-CM does not list Includes notes for D86.82 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D86.82 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D86.82 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D86.82 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D86.82 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must specify sarcoidosis as the established etiology of the cranial nerve palsies, with identification of which cranial nerves are affected.

Supporting evidence should include MRI findings (leptomeningeal enhancement, cranial nerve enhancement), cerebrospinal fluid analysis, and histologic confirmation of sarcoidosis.

Treatment plan including corticosteroids or steroid-sparing immunosuppressants should be documented.

MEAT Support

HCC Buddy guidance

Documentation must specify sarcoidosis as the established etiology of the cranial nerve palsies, with identification of which cranial nerves are affected.

Supporting evidence should include MRI findings (leptomeningeal enhancement, cranial nerve enhancement), cerebrospinal fluid analysis, and histologic confirmation of sarcoidosis.

Treatment plan including corticosteroids or steroid-sparing immunosuppressants should be documented.

Audit Caution

HCC Buddy guidance

This code specifically requires MULTIPLE cranial nerve involvement

if only a single cranial nerve is affected by sarcoidosis, a different code may be more appropriate. Do not assign this code based on suspected neurosarcoidosis without documented confirmation of the diagnosis. Ensure the cranial nerve palsies are currently active, not resolved historical findings.

Common Mistakes

HCC Buddy guidance

G52.7 (Disorders of multiple cranial nerves) captures multiple cranial neuropathies from other causes but should not be used when sarcoidosis is the documented etiology.

D86.89 (Sarcoidosis of other sites) might be used incorrectly instead of this more specific neurosarcoidosis code.

G51.0 (Bell's palsy) should not be assigned when facial nerve palsy is attributed to sarcoidosis.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is D86.82 an HCC code?

Yes. D86.82 maps to Myasthenia Gravis/Myoneural Conditions and Guillain-Barre Syndrome under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 75, Myasthenia Gravis/Myoneural Conditions and Guillain-Barre Syndrome

0.425

ESRDHCC 75, Myasthenia Gravis/Myoneural Conditions and Guillain-Barre Syndrome

0.000

RxHCCHCC 158, Guillain-Barre Syndrome and Other Polyneuropathies

0.000

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 D86.82

For D86.82to 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 D86.82 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D86.82 is the ICD-10-CM diagnosis code for multiple cranial nerve palsies in sarcoidosis. A condition where sarcoidosis, an inflammatory disease, affects multiple nerves in the head and face, causing weakness or paralysis of facial muscles and other cranial nerve functions. D86.82 sits in the ICD-10-CM chapter for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (d50-d89), within the section covering certain disorders involving the immune mechanism (d80-d89).

Under the older CMS-HCC V24 model, D86.82 maps to Myasthenia Gravis/Myoneural Conditions and Guillain-Barre Syndrome (HCC 75) with a community, non-dual, aged base RAF weight of 0.425. 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.

Specify which cranial nerves are affected when documentation is available. Because D86.82 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 D86.82 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Specify which cranial nerves are affected when documentation is available
•This code indicates sarcoidosis with neurological complications; ensure the primary sarcoidosis diagnosis is also coded

Clinical Significance

Multiple cranial nerve palsies due to sarcoidosis represents significant neurosarcoidosis, a serious complication affecting approximately 5-10% of sarcoidosis patients. Cranial nerve VII (facial nerve) is most commonly involved, but multiple nerve involvement indicates more extensive leptomeningeal or basilar inflammation. This presentation carries a worse prognosis than single nerve involvement and often requires aggressive immunosuppressive therapy.

Documentation Requirements

✓Documentation must specify sarcoidosis as the established etiology of the cranial nerve palsies, with identification of which cranial nerves are affected.
✓Supporting evidence should include MRI findings (leptomeningeal enhancement, cranial nerve enhancement), cerebrospinal fluid analysis, and histologic confirmation of sarcoidosis.
✓Treatment plan including corticosteroids or steroid-sparing immunosuppressants should be documented.

Commonly Confused Codes

•G52.7 (Disorders of multiple cranial nerves) captures multiple cranial neuropathies from other causes but should not be used when sarcoidosis is the documented etiology.
•D86.89 (Sarcoidosis of other sites) might be used incorrectly instead of this more specific neurosarcoidosis code.
•G51.0 (Bell's palsy) should not be assigned when facial nerve palsy is attributed to sarcoidosis.