G06.1
BillableIntraspinal abscess and granuloma
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G06.1 an HCC code?
No. G06.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
G06.1 is the ICD-10-CM diagnosis code for intraspinal abscess and granuloma. An intraspinal abscess and granuloma is a collection of pus or inflammatory tissue within the spinal canal that can cause pain, weakness, or numbness in the back and limbs. This condition requires prompt medical attention as it can potentially damage the spinal cord if left untreated. G06.1 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).
G06.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify the specific location of the abscess or granuloma (cervical, thoracic, lumbar, or sacral spine) as this may require additional specificity codes or documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G06.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific location of the abscess or granuloma (cervical, thoracic, lumbar, or sacral spine) as this may require additional specificity codes or documentation
- •Distinguish between intraspinal abscess (typically infectious) and granuloma (often inflammatory or infectious like tuberculosis) as the underlying cause affects treatment and may require additional diagnosis codes
Excludes 1 — Do NOT code together
- tuberculous intraspinal abscess and granuloma (A17.81)