G93.41 ICD-10-CM Code: Metabolic encephalopathy
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Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 1 inclusion term · 4 Excludes2
Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.
What you need to know
Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.
- Excludes2Not included here; may be reported together
- IncludesWhat this code covers
- Septic encephalopathy
Most relevant related codes MedCoder-derived
Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.
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 v44, Appendix B.
- MS-DRG 070 — OTHER CEREBROVASCULAR DISORDERS WITH MCC (MDC 01)
- MS-DRG 071 — OTHER CEREBROVASCULAR DISORDERS WITH CC (MDC 01)
- MS-DRG 072 — OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC (MDC 01)
- MS-DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)
- MS-DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)
- MS-DRG 976 — HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC (MDC 25)
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.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for G93.41 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026
Trace:FY2027 changesChange historyRelease, file and checksum
Notes without a marker are published on G93.41 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Septic encephalopathy
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- alcoholic encephalopathy (G31.2) Compare G93.41 vs G31.2 →
- encephalopathy in diseases classified elsewhere (G94) Compare G93.41 vs G94 →
- hypertensive encephalopathy (I67.4) Compare G93.41 vs I67.4 →
- toxic (metabolic) encephalopathy (G92.8) Compare G93.41 vs G92.8 →
Source: inherited from G93.4
Coder workflow for G93.41
MedCoder structured workflow — derived from this code’s own official record
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).
- The associated condition or complication
- Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Official instructions as workflow
Excludes2 — not part of G93.41(4 notes)
Coding workflow: The conditions named in this note are not included in G93.41. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareG31.2, G94, I67.4, G92.8
See the official tabular notes · Guidelines I.A.12.b
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.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
Code Overview
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
- MCC as a secondary diagnosis (FY2027). 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-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name G93.41 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 3 Use Additional Code instructions across 2 chapters: M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA], R65.11 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction, R65.2 — Severe sepsis.
These codes instruct coders to additionally report this code when it applies.
Referenced by 1 Code Also instruction: F78.A1 — SYNGAP1-related intellectual disability (via G93.4.-).
These codes suggest coding this condition alongside when both are present.
MS-DRG Grouper Relationships (FY2027)
Potential MS-DRG participation — not a DRG assignment.
FY2027 MS-DRG: MCC — Major 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 10 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 974-976 (HIV with Major Related Condition).
Named in the grouper logic of 6 MS-DRGs: DRG 070 (MDC 01), DRG 071 (MDC 01), DRG 072 (MDC 01), DRG 974 (MDC 25), DRG 975 (MDC 25), DRG 976 (MDC 25).
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 MCC — 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.
G21.0 — Malignant neuroleptic syndrome, G83.5 — Locked-in state, G93.40 — Encephalopathy, unspecified, 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 clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other nervous system disorders (neither hereditary nor degenerative)).
G92.05 — Immune effector cell-associated neurotoxicity syndrome, grade 5, G92.8 — Other toxic encephalopathy, G92.9 — Unspecified toxic encephalopathy, G93.0 — Cerebral cysts, G93.2 — Benign intracranial hypertension, G93.3 — Postviral and related fatigue syndromes, G93.31 — Postviral fatigue syndrome, G93.32 — Myalgic encephalomyelitis/chronic fatigue syndrome, G93.39 — Other post infection and related fatigue syndromes, G93.40 — Encephalopathy, unspecified, G93.49 — Other encephalopathy, G93.5 — Compression of brain, G93.6 — Cerebral edema, G93.7 — Reye's syndrome, G93.81 — Temporal sclerosis, G93.82 — Brain death, G93.89 — Other specified disorders of brain, G93.9 — Disorder of brain, unspecified, G94 — Other disorders of brain in diseases classified elsewhere, G95.0 — Syringomyelia and syringobulbia, +97 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Encephalopathy”; these codes share that main term but sit in a different category of the Tabular List.
G04.31 — Postinfectious acute necrotizing hemorrhagic encephalopathy (acute necrotizing hemorrhagic, postinfectious), G04.32 — Postimmunization acute necrotizing hemorrhagic encephalopathy (acute necrotizing hemorrhagic, postimmunization), G04.39 — Other acute necrotizing hemorrhagic encephalopathy (acute necrotizing hemorrhagic, specified NEC), G31.2 — Degeneration of nervous system due to alcohol (alcoholic), G31.82 — Leigh's disease (necrotizing, subacute), G32.89 — Other specified degenerative disorders of nervous system in diseases classified elsewhere (degenerative, in specified disease NEC), G37.0 — Diffuse sclerosis of central nervous system (centrolobar progressive), G37.1 — Central demyelination of corpus callosum (demyelinating callosal), G92.8 — Other toxic encephalopathy (due to, drugs), G92.9 — Unspecified toxic encephalopathy (toxic), I67.2 — Cerebral atherosclerosis (arteriosclerotic), I67.4 — Hypertensive encephalopathy (hypertensive), K76.82 — Hepatic encephalopathy (hepatic), P11.1 — Other specified brain damage due to birth injury (in, birth injury), P57.0 — Kernicterus due to isoimmunization (hyperbilirubinemic, newborn, due to isoimmunization), P57.9 — Kernicterus, unspecified (hyperbilirubinemic, newborn), P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified (hypoxic ischemic), P91.61 — Mild hypoxic ischemic encephalopathy [HIE] (hypoxic ischemic, mild), P91.62 — Moderate hypoxic ischemic encephalopathy [HIE] (hypoxic ischemic, moderate), P91.63 — Severe hypoxic ischemic encephalopathy [HIE] (hypoxic ischemic, severe), +17 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Contextual Map
Every relationship of G93.41 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 G93.41 with these 4 related codes in Claim Check
Hierarchy
- G00-G99 — Chapter 6: Diseases of the Nervous System (G00-G99) (G00-G99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Referenced by Use Additional Code instructions
- M31.11 — Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA][Use Additional Code]: “encephalopathy (metabolic) (septic) (G93.41)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- R65.11 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction[Use Additional Code]: “encephalopathy (metabolic) (septic) (G93.41)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
- R65.2 — Severe sepsis[Use Additional Code]: “encephalopathy (metabolic) (septic) (G93.41)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Referenced by Code Also instructions
- F78.A1 — SYNGAP1-related intellectual disability[Code Also](via G93.4.-): “encephalopathy (G93.4-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Clinical classification (CCSR)
- NVS020 — Other nervous system disorders (neither hereditary nor degenerative)[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC). Not counted when the stay groups to DRGs 974-976 (HIV with Major Related Condition).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
- DRG 070 — OTHER CEREBROVASCULAR DISORDERS WITH MCC[MS-DRG]: “OTHER CEREBROVASCULAR DISORDERS WITH MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 071 — OTHER CEREBROVASCULAR DISORDERS WITH CC[MS-DRG]: “OTHER CEREBROVASCULAR DISORDERS WITH CC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 072 — OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC[MS-DRG]: “OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC[MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC[MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 976 — HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC[MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC (MDC 25)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
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. 8,919 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
- MDC 25 — Human Immunodeficiency Virus Infections[MDC crossing]: “Human Immunodeficiency Virus Infections — 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.”— CMS MS-DRG Definitions Manual · FY2027
Index entries
- Encephalopathy (acute), metabolic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Encephalopathy (acute), septic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
Nearest codes (23)
- G93 — Other disorders of brain[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.0 — Cerebral cysts[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.1 — Anoxic brain damage, not elsewhere classified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.2 — Benign intracranial hypertension[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.3 — Postviral and related fatigue syndromes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.31 — Postviral fatigue syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.32 — Myalgic encephalomyelitis/chronic fatigue syndrome[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- G93.39 — Other post infection and related fatigue syndromes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- and 15 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Indexed Clinical Terms (2)
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.
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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
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. "G93.41 — Metabolic encephalopathy." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/g93.41-metabolic-encephalopathy
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionMetabolic encephalopathy
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 G93.41 in its code family, with their registry titles.
- G93.31 — Postviral fatigue syndrome
- G93.32 — Myalgic encephalomyelitis/chronic fatigue syndrome
- G93.39 — Other post infection and related fatigue syndromes
- G93.4 — Other and unspecified encephalopathy
- G93.40 — Encephalopathy, unspecified
- 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