G96.11 — Dural tear
Is G96.11 billable?
Yes — G96.11 is billable for FY2027. G96.11 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. G96.11 may be submitted for encounters from October 1, 2026 through September 30, 2027.
G96.11 at a glance
| Code | G96.11 |
|---|---|
| Description | Dural tear |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does G96.11 group to?
G96.11 sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 791Prematurity with Major Problemsmedical
As a secondary diagnosis, G96.11 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is G96.11 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to G96.11. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Tear, torn › dural › nontraumatic (traumatic)
Excludes1 — never code together
The conditions below can never be reported together with G96.11 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- accidental puncture or laceration of dura during a procedure (G97.41)
Code also
Two codes may be needed to describe the condition fully. Whether G96.11 is sequenced first depends on the reason for the encounter.
- intracranial hypotension, if applicable (G96.81-)
Excludes2 — not included here — inherited from Chapter 6
The conditions below are not part of G96.11, but a patient may have both at the same time. When documentation supports it, G96.11 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 G96.11 existed?
G96.11 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.