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G96.0 ICD-10-CM Code: Cerebrospinal fluid leak

G96.0 is not a CMS-HCC payment code. 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)

G96.0

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

Cerebrospinal fluid leak

Cerebrospinal fluid leak

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
G96Other disorders of central nervous system
G96.0Cerebrospinal fluid leak

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G96.0 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G96.0 in this effective period.

Related Child Codes

Official
G96.00Cerebrospinal fluid leak, unspecified
G96.01Cranial cerebrospinal fluid leak, spontaneous
G96.02Spinal cerebrospinal fluid leak, spontaneous
G96.08Other cranial cerebrospinal fluid leak
G96.09Other spinal cerebrospinal fluid leak

Includes

Official

ICD-10-CM does not list Includes notes for G96.0 in this effective period.

Excludes 1

Official
  • cerebrospinal fluid leak from spinal puncture (G97.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G96.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G96.0 in this effective period.

Code Also

Official
  • if applicable:
  • intracranial hypotension (G96.81-)

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 →

Code
G96.0
Description
Cerebrospinal fluid leak
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

G96.0 is the ICD-10-CM diagnosis code for cerebrospinal fluid leak. G96.0 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).

Header codes like G96.0 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 G96.0'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 G96.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • cerebrospinal fluid leak from spinal puncture (G97.0)

Code Also

  • if applicable:
  • intracranial hypotension (G96.81-)

Child Codes

Code Hierarchy

G96.0 code history

Code setChange
FY2021 (effective Oct 1, 2020)Billability changed (now non-billable header)

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

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