G93.49 ICD-10-CM Code: Other encephalopathy

G93.49 is the ICD-10-CM diagnosis code for other encephalopathy. This code describes inflammation or dysfunction of the brain that doesn't fit into other specific encephalopathy categories. It's used when a patient has brain swelling or brain dysfunction from various causes that aren't more precisely defined. G93.49 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).

G93.49 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.

Always review the clinical documentation to identify the underlying cause of encephalopathy (toxic, metabolic, anoxic, etc.) as more specific codes may be available and preferred.