What is the ICD-10 code for MS?

The ICD-10-CM code for MS (multiple sclerosis) is G35. G35 is a non-billable header code in the FY2026 ICD-10-CM code set used on Medicare Advantage and commercial claims. It maps to CMS-HCC V28 category 198 (RAF 0.647), so it counts toward the patient's risk adjustment score.

What is ICD-10 code G35?

G35 is the ICD-10-CM diagnosis code for Multiple sclerosis. It belongs to the ICD-10-CM chapter for diseases of the nervous system (g00-g99). G35 is a non-billable header code that organizes more specific child codes; the actual diagnosis on a claim must use one of those children. G35 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. G35 is a payment HCC under the CMS risk adjustment model. Under the CMS-HCC V28 risk adjustment model it maps to Multiple Sclerosis with a community, non-dual, aged base RAF weight of 0.647. Under the older CMS-HCC V24 model it maps to Multiple Sclerosis at RAF 0.423. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. HCC Buddy maintains the V28 and V24 mapping, RAF weight, and MEAT documentation criteria for G35 sourced directly from the CMS-HCC model files.

No. G35 is a header (non-billable) ICD-10-CM code. Header codes sit at a higher level of the diagnosis hierarchy and exist to organize a family of more specific child codes. Per ICD-10-CM coding guidelines, a header code cannot be reported on a claim as the diagnosis, coders must select a billable child code from the G35 hierarchy that matches the highest level of specificity supported by the provider's documentation. Payers reject header codes submitted as the primary diagnosis.

What is the V28 vs V24 difference for G35?

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 G35, V28 maps to Multiple Sclerosis at RAF 0.647 while V24 mapped to Multiple Sclerosis at RAF 0.423. Both models can still appear in legacy data and in payer-specific lookback periods.

2026 ICD-10-CM G35: Multiple sclerosis

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Code lookupG35Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Demyelinating diseases of the central nervous system (G35-G37)

G35

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Multiple sclerosis

CMS-HCC V28

Mapped

HCC 198

Multiple Sclerosis

RAF 0.647

CMS-HCC V24

Mapped

HCC 77

Multiple Sclerosis

RAF 0.423

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 77

Multiple Sclerosis

RAF 0.111

RXHCC

Mapped

HCC 159

Multiple Sclerosis

RAF 3.733

Code Book Path

Official

G3Demyelinating diseases of the central nervous system (G35-G37)

G35Multiple sclerosis

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G35 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G35 in this effective period.

Related Child Codes

Official

G35.ARelapsing-remitting multiple sclerosis

G35.BPrimary progressive multiple sclerosis

G35.CSecondary progressive multiple sclerosis

G35.DMultiple sclerosis, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for G35 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G35 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G35 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G35 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G35 in this effective period.

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 G35 an HCC code?

Yes. G35 (Multiple sclerosis) maps to Multiple Sclerosis under the CMS-HCC V28 risk adjustment model (and Multiple Sclerosis under V24), with a community non-dual aged RAF of 0.647. It is a non-billable header code for payment year 2026.

Coder answer: G35 is a non-billable header code and maps to V28 HCC 198, Multiple Sclerosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: G35
Description: Multiple sclerosis
HCC (V28): HCC 198 — Multiple Sclerosis
RAF: 0.647
Billable: No
Payment year: 2026

HCC Category Mapping

V28HCC 198, Multiple Sclerosis

0.647

V24HCC 77, Multiple Sclerosis

0.423

ESRDHCC 77, Multiple Sclerosis

0.111

RxHCCHCC 159, Multiple Sclerosis

3.733

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 G35 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for G35

For G35 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 G35 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

G35 is the ICD-10-CM diagnosis code for multiple sclerosis. G35 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering demyelinating diseases of the central nervous system (g35-g37).

Under the CMS-HCC V28 risk adjustment model, G35 maps to Multiple Sclerosis (HCC 198) with a community, non-dual, aged base RAF weight of 0.647. Under the older V24 model, G35 mapped to the same category but with a base RAF weight of 0.423, 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.

Header codes like G35 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 G35'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 G35 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.