G92.04 — Immune effector cell-associated neurotoxicity syndrome, grade 4
Is G92.04 billable?
Yes — G92.04 is billable for FY2027. G92.04 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. G92.04 may be submitted for encounters from October 1, 2026 through September 30, 2027.
G92.04 at a glance
| Code | G92.04 |
|---|---|
| Description | Immune effector cell-associated neurotoxicity syndrome, grade 4 |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to G92.04?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name G92.04 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does G92.04 group to?
G92.04 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, G92.04 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is G92.04 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to G92.04. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Syndrome › immune effector cell-associated neurotoxicity › grade › 4
Inclusion terms
Alternative wording in documentation that is classified to G92.04.
- ICANS, grade 4
Code first — inherited from G92.0
The underlying condition below must be sequenced before G92.04. G92.04 describes a manifestation and cannot be the principal or first-listed diagnosis.
- underlying cause such as:
- complications of immune effector cellular therapy (T80.82)
Excludes2 — not included here — inherited from Chapter 6
The conditions below are not part of G92.04, but a patient may have both at the same time. When documentation supports it, G92.04 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)
Code also — inherited from G92.0
Two codes may be needed to describe the condition fully. Whether G92.04 is sequenced first depends on the reason for the encounter.
How long has G92.04 existed?
G92.04 first appears in FY2022.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the G92.0 family? (5)
- G92.00Immune effector cell-associated neurotoxicity syndrome, grade unspecified
- G92.01Immune effector cell-associated neurotoxicity syndrome, grade 1
- G92.02Immune effector cell-associated neurotoxicity syndrome, grade 2
- G92.03Immune effector cell-associated neurotoxicity syndrome, grade 3
- G92.05Immune effector cell-associated neurotoxicity syndrome, grade 5