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G35 ICD-10-CM Code: Multiple sclerosis

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 77 · RxHCC V08 category 159

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 198 — Multiple Sclerosis

Other models: CMS-HCC V22 HCC 77 · RxHCC V08 HCC 159

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coder workflow for G35

MedCoder structured workflow — derived from this code’s own official record

Before you code G35

  1. G35 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewG35.A, G35.B, G35.C, G35.D

    See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath G35?
    Yes → Select that code and continue the checks below on its own page.
    No → G35 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewG35.A, G35.B, G35.C, G35.D

Consider G35. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Multiple sclerosis is a non-billable ICD-10-CM category code (G35). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name G35 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: G37.3 — Acute transverse myelitis in demyelinating disease of central nervous system.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: G04 — Encephalitis, myelitis and encephalomyelitis.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 2 Code First instructions: F02 — Dementia in other diseases classified elsewhere, F48.2 — Pseudobulbar affect.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Clinical classification (AHRQ CCSR):NVS005 — Multiple sclerosis (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Multiple Sclerosis) for risk-adjusted payment.

G35.A — Relapsing-remitting multiple sclerosis, G35.B0 — Primary progressive multiple sclerosis, unspecified, G35.B1 — Active primary progressive multiple sclerosis, G35.B2 — Non-active primary progressive multiple sclerosis, G35.C0 — Secondary progressive multiple sclerosis, unspecified, G35.C1 — Active secondary progressive multiple sclerosis, G35.C2 — Non-active secondary progressive multiple sclerosis, G35.D — Multiple sclerosis, unspecified, G36.0 — Neuromyelitis optica [Devic], G36.1 — Acute and subacute hemorrhagic leukoencephalitis [Hurst], G36.8 — Other specified acute disseminated demyelination, G36.9 — Acute disseminated demyelination, unspecified, G37.0 — Diffuse sclerosis of central nervous system, G37.1 — Central demyelination of corpus callosum, G37.2 — Central pontine myelinolysis, G37.5 — Concentric sclerosis [Balo] of central nervous system, G37.81 — Myelin oligodendrocyte glycoprotein antibody disease, G37.89 — Other specified demyelinating diseases of central nervous system, G37.9 — Demyelinating disease of central nervous system, unspecified

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Multiple sclerosis).

G35.A — Relapsing-remitting multiple sclerosis, G35.B0 — Primary progressive multiple sclerosis, unspecified, G35.B1 — Active primary progressive multiple sclerosis, G35.B2 — Non-active primary progressive multiple sclerosis, G35.C0 — Secondary progressive multiple sclerosis, unspecified, G35.C1 — Active secondary progressive multiple sclerosis, G35.C2 — Non-active secondary progressive multiple sclerosis, G35.D — Multiple sclerosis, unspecified

Contextual Map

Every relationship of G35 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run G35 with these 4 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 198 — Multiple Sclerosis [CMS-HCC]— CMS-HCC V28 · 2026

Nearest codes (10)

Change history (2)

Common coding questions

Can G35 be billed directly?

No. G35 (Multiple sclerosis) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "G35 — Multiple sclerosis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/g35-multiple-sclerosis

Change history

  • FY2026 — October 1, 2025
    Became a non-billable header
    FY2026 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Multiple sclerosis

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G35 in its code family, with their registry titles.