G04 vs G92.8
G04 (Encephalitis, myelitis and encephalomyelitis) compared with G92.8 (Other toxic encephalopathy), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. G04 carries an Excludes2 note covering G92.8: “toxic encephalitis (G92.8)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. G04 carries an Excludes2 note covering G92.8: “toxic encephalopathy (G92.8)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| G04Encephalitis, myelitis and encephalomyelitis | G92.8Other toxic encephalopathy | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | G00-G99 — Diseases of the Nervous System (G00-G99) | G00-G99 — Diseases of the Nervous System (G00-G99) |
| Definition | Encephalitis, myelitis and encephalomyelitis is a non-billable ICD-10-CM category code (G04). | Other toxic encephalopathy is a billable ICD-10-CM diagnosis code (G92.8). |
| Includes | acute ascending myelitis meningoencephalitis meningomyelitis | Toxic encephalitis Toxic metabolic encephalopathy |
| Use additional code | — | code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) |
| Code first | — | poisoning due to drug or toxin, if applicable, (T36-T65 with fifth or sixth character 1-4) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources