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G36.0 ICD-10-CM Code: Neuromyelitis optica [Devic]

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 inclusion term · 1 Excludes1 · 1 Excludes2
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 77 · RxHCC V08 category 159

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 058 — MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC (MDC 01)
  • MS-DRG 059 — MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC (MDC 01)
  • MS-DRG 060 — MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for G36.0 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on G36.0 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Demyelination in optic neuritis

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from G36

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for G36.0

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

Before you code G36.0

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with G36.0. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in G36.0’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewG04.01

Consider G36.0. 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).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).

Official instructions as workflow

  • Excludes1 — check before selecting G36.0(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with G36.0: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareG04.01

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of G36.0(1 note)

    Coding workflow: The conditions named in this note are not included in G36.0. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareH46

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition G36.0 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewG04.01

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

Neuromyelitis optica [Devic] is a billable ICD-10-CM diagnosis code (G36.0).

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

Indexed Clinical Terms (9)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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 G36.0 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: H46 — Optic neuritis.

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

Referenced by 1 Code Also instruction: G37.81 — Myelin oligodendrocyte glycoprotein antibody disease.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 9 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 058 (MDC 01), DRG 059 (MDC 01), DRG 060 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS020 — Other nervous system disorders (neither hereditary nor degenerative) (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 clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

G93.40 — Encephalopathy, unspecified, G93.41 — Metabolic encephalopathy, G93.42 — Megalencephalic leukoencephalopathy with subcortical cysts, G93.43 — Leukoencephalopathy with calcifications and cysts, G93.44 — Adult-onset leukodystrophy with axonal spheroids, G93.45 — Developmental and epileptic encephalopathy, G93.49 — Other encephalopathy, I67.83 — Posterior reversible encephalopathy syndrome

Same CMS-HCC risk category (V28)

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

G35 — 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, 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 (Other nervous system disorders (neither hereditary nor degenerative)).

E10.44 — Type 1 diabetes mellitus with diabetic amyotrophy, E11.40 — Type 2 diabetes mellitus with diabetic neuropathy, unspecified, E11.44 — Type 2 diabetes mellitus with diabetic amyotrophy, E13.40 — Other specified diabetes mellitus with diabetic neuropathy, unspecified, E13.44 — Other specified diabetes mellitus with diabetic amyotrophy, G08 — Intracranial and intraspinal phlebitis and thrombophlebitis, G13.0 — Paraneoplastic neuromyopathy and neuropathy, G13.1 — Other systemic atrophy primarily affecting central nervous system in neoplastic disease, G13.2 — Systemic atrophy primarily affecting the central nervous system in myxedema, G13.8 — Systemic atrophy primarily affecting central nervous system in other diseases classified elsewhere, 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, G37.3 — Acute transverse myelitis in demyelinating disease of central nervous system, G37.4 — Subacute necrotizing myelitis of central nervous system, G37.5 — Concentric sclerosis [Balo] of central nervous system, G37.8 — Other specified demyelinating diseases of central nervous system, +97 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Demyelination, demyelinization”, “Myelitis”, “Neuritis”, …; these codes share that main term but sit in a different category of the Tabular List.

B89 — Unspecified parasitic disease (acoustic, in, parasitic disease NEC), B99 — Other and unspecified infectious diseases (acoustic, in, infectious disease NEC), E51.11 — Dry beriberi (endemic), E85.4 — Organ-limited amyloidosis (amyloid, any site), G04.02 — Postimmunization acute disseminated encephalitis, myelitis and encephalomyelitis (postvaccinal), G04.82 — Acute flaccid myelitis (flaccid), G04.89 — Other myelitis (specified NEC), G04.91 — Myelitis, unspecified, G05.4 — Myelitis in diseases classified elsewhere (in diseases classified elsewhere), G35.D — Multiple sclerosis, unspecified (global), G37.1 — Central demyelination of corpus callosum (corpus callosum), G37.3 — Acute transverse myelitis in demyelinating disease of central nervous system (transverse), G37.4 — Subacute necrotizing myelitis of central nervous system (necrotizing, subacute), G37.89 — Other specified demyelinating diseases of central nervous system (central nervous system, specified NEC), G37.9 — Demyelinating disease of central nervous system, unspecified (central nervous system), G51.1 — Geniculate ganglionitis (geniculate ganglion), G51.8 — Other disorders of facial nerve (facial), G52.0 — Disorders of olfactory nerve (olfactory nerve), G52.2 — Disorders of vagus nerve (vagus), G52.3 — Disorders of hypoglossal nerve (hypoglossal), +35 more

Contextual Map

Every relationship of G36.0 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 G36.0 with these 3 related codes in Claim Check

Hierarchy

Excludes2

  • H46 — Optic neuritis[Excludes2]: “optic neuritis NOS (H46)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

Referenced by Excludes2 notes

  • H46 — Optic neuritis[Excludes2]: “neuromyelitis optica [Devic] (G36.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

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

MS-DRG Grouper

MDC crossing

  • MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 8,892 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries (9)

  • Demyelination, demyelinization, in optic neuritis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Devic's disease[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Disease, diseased, Devic's[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Myelitis (acute) (ascending) (childhood) (chronic) (descending) (diffuse) (disseminated) (idiopathic) (pressure) (progressive) (spinal cord) (subacute), optic neuritis in[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neuritis (rheumatoid), optic (nerve) (hereditary) (sympathetic), in myelitis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neuritis (rheumatoid), optic (nerve) (hereditary) (sympathetic), with demyelination[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neuroencephalomyelopathy, optic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Neuromyelitis, optica[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • and 1 more

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 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. "G36.0 — Neuromyelitis optica [Devic]." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/g36.0-neuromyelitis-optica-devic

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Neuromyelitis optica [Devic]

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G36.0 in its code family, with their registry titles.

View all codes in the G36 family