G92.01 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupG92.01

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Other disorders of the nervous system (G89-G99)

G92.01

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

Immune effector cell-associated neurotoxicity syndrome, grade 1

A mild neurological side effect from immunotherapy treatment where the patient experiences minimal symptoms affecting brain function.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

G92Toxic encephalopathy G92.0Immune effector cell-associated neurotoxicity syndrome G92.01Immune effector cell-associated neurotoxicity syndrome, grade 1

Inclusion Terms

Official

ICANS, grade 1

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from G00-G99
certain infectious and parasitic diseases (A00-B99)Inherited from G00-G99
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from G00-G99
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from G00-G99
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from G00-G99
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from G00-G99
neoplasms (C00-D49)Inherited from G00-G99
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from G00-G99

Related Codes

Official

G92.00Immune effector cell-associated neurotoxicity syndrome, grade unspecified G92.02Immune effector cell-associated neurotoxicity syndrome, grade 2 G92.03Immune effector cell-associated neurotoxicity syndrome, grade 3 G92.04Immune effector cell-associated neurotoxicity syndrome, grade 4 G92.05Immune effector cell-associated neurotoxicity syndrome, grade 5

Includes

Official

No Includes notes are included in this display for G92.01. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for G92.01. Check the code and parent instructions in the Code Book.

Code First

Official

underlying cause such as:Inherited from G92.0
complications of immune effector cellular therapy (T80.82)Inherited from G92.0

Use Additional

Official

No Use Additional Code instructions are included in this display for G92.01. Check the code and parent instructions in the Code Book.

Code Also

Official

, if applicable, associated signs and symptoms, such as:Inherited from G92.0
cerebral edema (G93.6)Inherited from G92.0
unspecified convulsions (R56.9)Inherited from G92.0

Buddy Documentation Tip

HCC Buddy guidance

Ensure documentation clearly indicates Grade 1 severity to justify this specific code

Document the type of immunotherapy (CAR-T, checkpoint inhibitor, etc.) in the medical record

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 G92.01 an HCC code?

No. G92.01 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: G92.01
Description: Immune effector cell-associated neurotoxicity syndrome, grade 1
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

G92.01 is the ICD-10-CM diagnosis code for immune effector cell-associated neurotoxicity syndrome, grade 1. A mild neurological side effect from immunotherapy treatment where the patient experiences minimal symptoms affecting brain function. G92.01 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering other disorders of the nervous system (g89-g99).

G92.01 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Ensure documentation clearly indicates Grade 1 severity to justify this specific code.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for G92.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation clearly indicates Grade 1 severity to justify this specific code
•Document the type of immunotherapy (CAR-T, checkpoint inhibitor, etc.) in the medical record