ICDcodes.org
FY2027

G05.3Encephalitis and encephalomyelitis in diseases classified elsewhere

BillableMCC

Is G05.3 billable?

Yes — G05.3 is billable for FY2027. G05.3 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. G05.3 may be submitted for encounters from October 1, 2026 through September 30, 2027.

G05.3 at a glance

CodeG05.3
DescriptionEncephalitis and encephalomyelitis in diseases classified elsewhere
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to G05.3?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name G05.3 directly.

Manifestation code — never sequenced first — MCE edit 6

This code describes a manifestation of an underlying disease. The underlying condition must be sequenced before it, so it can never be the principal or first-listed diagnosis.

Which MS-DRGs does G05.3 group to?

G05.3 sits in MDC 01 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 023Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis with MCC or Antineoplastic Implant or Epilepsy with Neurostimulatorsurgical
  • 024Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCCsurgical

As a secondary diagnosis, G05.3 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.

How is G05.3 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to G05.3. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Encephalitislupus erythematosus, systemic (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalitisotitic NEC (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalitistrichinosis (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalomyelitisin diseases classified elsewhere
  • Meningoencephalitisparasitic NEC
  • Encephalitisdue tohuman immunodeficiency virusdisease (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • EncephalitisinAfrican trypanosomiasis (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalitisininfectious disease NEC (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalitisinparasitic disease NEC (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalitisinpoliovirus (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Encephalitisinsystemic lupus erythematosus (chronic) (hemorrhagic) (idiopathic) (nonepidemic) (spurious) (subacute)
  • Meningoencephalitisindiseases classified elsewhere

Code first

The underlying condition below must be sequenced before G05.3. G05.3 describes a manifestation and cannot be the principal or first-listed diagnosis.

  • underlying disease

Inclusion terms

Alternative wording in documentation that is classified to G05.3.

  • Meningoencephalitis in diseases classified elsewhere

Excludes1 — never code together — inherited from G05

The conditions below can never be reported together with G05.3 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • adenoviral encephalitis, myelitis and encephalomyelitis (A85.1)
  • encephalitis, myelitis and encephalomyelitis (in) measles (B05.0)
  • enteroviral encephalitis, myelitis and encephalomyelitis (A85.0)
  • herpesviral [herpes simplex] encephalitis, myelitis and encephalomyelitis (B00.4)
  • listerial encephalitis, myelitis and encephalomyelitis (A32.12)
  • meningococcal encephalitis, myelitis and encephalomyelitis (A39.81)
  • mumps encephalitis, myelitis and encephalomyelitis (B26.2)
  • postchickenpox encephalitis, myelitis and encephalomyelitis (B01.1-)
  • rubella encephalitis, myelitis and encephalomyelitis (B06.01)
  • toxoplasmosis encephalitis, myelitis and encephalomyelitis (B58.2)
  • zoster encephalitis, myelitis and encephalomyelitis (B02.0)

Code first — inherited from G05

The underlying condition below must be sequenced before G05.3. G05.3 describes a manifestation and cannot be the principal or first-listed diagnosis.

  • underlying disease, such as:
  • congenital toxoplasmosis encephalitis, myelitis and encephalomyelitis (P37.1)
  • cytomegaloviral encephalitis, myelitis and encephalomyelitis (B25.8)
  • encephalitis, myelitis and encephalomyelitis (in) systemic lupus erythematosus (M32.19)
  • eosinophilic meningoencephalitis (B83.2)
  • human immunodeficiency virus [HIV] disease (B20)
  • poliovirus (A80.-)
  • suppurative otitis media (H66.01-H66.4)
  • systemic lupus erythematosus (M32.19)
  • trichinellosis (B75)

Excludes2 — not included here — inherited from Chapter 6

The conditions below are not part of G05.3, but a patient may have both at the same time. When documentation supports it, G05.3 and the excluded code may both be reported.

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

How long has G05.3 existed?

G05.3 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to G05.3?

What other codes are in the G05 family? (1)