G95.19 ICD-10-CM Code: Other vascular myelopathies
G95.19 maps to CMS-HCC V28 182. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Other disorders of the nervous system (G89-G99)
G95.19
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther vascular myelopathies
This code describes damage to the spinal cord caused by blood vessel problems other than the common types (like spinal cord infarction or hemorrhage). These vascular issues can reduce blood flow to the spinal cord, leading to weakness, numbness, or loss of function.
Buddy Insight
Other vascular myelopathies encompass non-infarction vascular conditions affecting the spinal cord, including venous congestion myelopathy, spinal dural arteriovenous fistula-related myelopathy, and subacute or chronic ischemic cord conditions.
CMS-HCC V28
MappedHCC 182
Coefficient HCC 182: 0.478 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 110
Code-level coefficient reference
ESRD/PACE
MappedHCC 72
Code-level coefficient reference
RXHCC
MappedHCC 155
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Edema of spinal cord
- Hematomyelia
- Nonpyogenic intraspinal phlebitis and thrombophlebitis
- Subacute necrotic myelopathy
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from G00-G99, G95, G95.1
- certain infectious and parasitic diseases (A00-B99)Inherited from G00-G99, G95, G95.1
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from G00-G99, G95, G95.1
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from G00-G99, G95, G95.1
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from G00-G99, G95, G95.1
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from G00-G99, G95, G95.1
- neoplasms (C00-D49)Inherited from G00-G99, G95, G95.1
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from G00-G99, G95, G95.1
- myelitis (G04.-)Inherited from G00-G99, G95, G95.1
- intraspinal phlebitis and thrombophlebitis, except non-pyogenic (G08)Inherited from G00-G99, G95, G95.1
Related Codes
Includes
OfficialNo Includes notes are included in this display for G95.19. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for G95.19. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for G95.19. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for G95.19. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for G95.19. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 G95.19 an HCC code?
Yes. G95.19 (Other vascular myelopathies) maps to HCC 182, Spinal Cord Disorders/Injuries under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.478. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: G95.19 is billable and maps to V28 HCC 182, Spinal Cord Disorders/Injuries. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- G95.19
- Description
- Other vascular myelopathies
- HCC (V28)
- HCC 182 — Spinal Cord Disorders/Injuries
- RAF reference coefficient
- 0.478
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work G95.19 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for G95.19
For G95.19, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
G95.19 is the ICD-10-CM diagnosis code for other vascular myelopathies. This code describes damage to the spinal cord caused by blood vessel problems other than the common types (like spinal cord infarction or hemorrhage). These vascular issues can reduce blood flow to the spinal cord, leading to weakness, numbness, or loss of function. G95.19 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).
Under the CMS-HCC V28 risk adjustment model, G95.19 maps to Spinal Cord Disorders/Injuries (HCC 182) with a source-labeled community, non-dual, aged reference coefficient of 0.478. No V24 mapping is shown for G95.19; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Use this code only when the vascular myelopathy doesn't fit into more specific categories like G95.11 (infarction) or G95.12 (hemorrhage); always document the underlying vascular condition if known. For G95.19, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for G95.19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the vascular myelopathy doesn't fit into more specific categories like G95.11 (infarction) or G95.12 (hemorrhage); always document the underlying vascular condition if known
- •Verify documentation clearly indicates a vascular cause of the spinal cord dysfunction; coordinate with the physician if the etiology is unclear to ensure accurate code selection
Clinical Significance
Other vascular myelopathies encompass non-infarction vascular conditions affecting the spinal cord, including venous congestion myelopathy, spinal dural arteriovenous fistula-related myelopathy, and subacute or chronic ischemic cord conditions. These conditions may present insidiously with progressive weakness and sensory changes. Identification is important because some forms (particularly dural arteriovenous fistulas) are surgically treatable.
Documentation Requirements
- ✓MRI demonstrating spinal cord signal abnormality consistent with vascular pathology
- ✓Spinal angiography results if performed, identifying any vascular malformation
- ✓Clinical documentation of progressive neurological symptoms and their vascular etiology
- ✓Differentiation from acute spinal cord infarction (which has its own code G95.11)
- ✓Treatment plan including any endovascular or surgical intervention
Commonly Confused Codes
- •G95.11: Acute infarction of spinal cord: use for acute vascular events with sudden onset
- •G95.0: Syringomyelia: non-vascular cavity formation within the cord
- •G95.89: Other specified diseases of spinal cord: non-vascular specified cord pathology
- •I67.1: Cerebral aneurysm, nonruptured: intracranial vascular lesion, not spinal