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G05

Non-Billable (Header)

Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

G05 is the ICD-10-CM diagnosis code for encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere. G05 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering inflammatory diseases of the central nervous system (g00-g09).

Header codes like G05 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at G05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1 — Do NOT code together

  • adenoviral encephalitis, myelitis and encephalomyelitis (A85.1)
  • encephalitis, myelitis and encephalomyelitis (in) measles (B05.0)
  • enteroviral encephalitis, myelitis and encephalomyelitis (A85.0)
  • herpesviral [herpes simplex] encephalitis, myelitis and encephalomyelitis (B00.4)
  • listerial encephalitis, myelitis and encephalomyelitis (A32.12)
  • meningococcal encephalitis, myelitis and encephalomyelitis (A39.81)
  • mumps encephalitis, myelitis and encephalomyelitis (B26.2)
  • postchickenpox encephalitis, myelitis and encephalomyelitis (B01.1-)
  • rubella encephalitis, myelitis and encephalomyelitis (B06.01)
  • toxoplasmosis encephalitis, myelitis and encephalomyelitis (B58.2)
  • zoster encephalitis, myelitis and encephalomyelitis (B02.0)

Code First

  • underlying disease, such as:
  • congenital toxoplasmosis encephalitis, myelitis and encephalomyelitis (P37.1)
  • cytomegaloviral encephalitis, myelitis and encephalomyelitis (B25.8)
  • encephalitis, myelitis and encephalomyelitis (in) systemic lupus erythematosus (M32.19)
  • eosinophilic meningoencephalitis (B83.2)
  • human immunodeficiency virus [HIV] disease (B20)
  • poliovirus (A80.-)
  • suppurative otitis media (H66.01-H66.4)
  • systemic lupus erythematosus (M32.19)
  • trichinellosis (B75)

Child Codes

Code Hierarchy

G05Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere
G05Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

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