{"code":"G04.0","type":"code","title":"Acute disseminated encephalitis and encephalomyelitis (ADEM)","codeAlso":[],"includes":["acute ascending myelitis","meningoencephalitis","meningomyelitis"],"modern_v":"official26","codeFirst":[],"excludes1":["acute necrotizing hemorrhagic encephalopathy (G04.3-)","other noninfectious acute disseminated encephalomyelitis (noninfectious ADEM) (G04.81)","encephalopathy NOS (G93.40)"],"excludes2":["acute transverse myelitis (G37.3)","alcoholic encephalopathy (G31.2)","multiple sclerosis (G35-)","myalgic encephalomyelitis (G93.32)","subacute necrotizing myelitis (G37.4)","toxic encephalitis (G92.8)","toxic encephalopathy (G92.8)"],"isBillable":false,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":false,"billableFy2027":false},"inclusionTerms":[],"useAdditionalCode":[],"clinicalDefinition":"Acute disseminated encephalitis and encephalomyelitis (ADEM) is a non-billable ICD-10-CM category code (G04.0). A more specific billable subcode must be selected for claims submission. Includes: acute ascending myelitis; meningoencephalitis; meningomyelitis. Excludes1 (not coded here): acute necrotizing hemorrhagic encephalopathy (G04.3-); other noninfectious acute disseminated encephalomyelitis (noninfectious ADEM) (G04.81); encephalopathy NOS (G93.40).","officialDefinition":"Acute disseminated encephalitis and encephalomyelitis (ADEM) is a non-billable ICD-10-CM category code (G04.0). A more specific billable subcode must be selected for claims submission. Includes: acute ascending myelitis; meningoencephalitis; meningomyelitis. Excludes1 (not coded here): acute necrotizing hemorrhagic encephalopathy (G04.3-); other noninfectious acute disseminated encephalomyelitis (noninfectious ADEM) (G04.81); encephalopathy NOS (G93.40). Excludes2 (not included here): acute transverse myelitis (G37.3); alcoholic encephalopathy (G31.2); multiple sclerosis (G35-); myalgic encephalomyelitis (G93.32); subacute necrotizing myelitis (G37.4); toxic encephalitis (G92.8); toxic encephalopathy (G92.8).","seventhCharacterInstructions":[],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":""}