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G93.6 ICD-10-CM Code: Cerebral edema

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

Coding at a Glance

Tabular directives
2 Excludes1
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 80

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 080 — NONTRAUMATIC STUPOR AND COMA WITH MCC (MDC 01)
  • MS-DRG 081 — NONTRAUMATIC STUPOR AND COMA WITHOUT 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 202 — Coma, Brain Compression/Anoxic Damage

Other models: CMS-HCC V22 HCC 80

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 G93.6 in the official ICD-10-CM tabular list, quoted as published.

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

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).

Coder workflow for G93.6

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

Before you code G93.6

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with G93.6. 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 G93.6’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.

    ReviewP11.0, S06.1

Consider G93.6. 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).

Official instructions as workflow

  • Excludes1 — check before selecting G93.6(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with G93.6: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareP11.0, S06.1

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

Coding decision scenarios

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

Documentation: Both the condition G93.6 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).

ReviewP11.0, S06.1

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

Cerebral edema is a billable ICD-10-CM diagnosis code (G93.6).

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 (7)

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

  • MCC 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 G93.6 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: R60 — Edema, not elsewhere classified.

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

Referenced by 1 Code Also instruction: G92.0 — Immune effector cell-associated neurotoxicity syndrome.

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: 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 2 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 080 (MDC 01), DRG 081 (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 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.

G93.82 — Brain death

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Coma, Brain Compression/Anoxic Damage) for risk-adjusted payment.

E03.5 — Myxedema coma, G93.1 — Anoxic brain damage, not elsewhere classified, G93.5 — Compression of brain, P91.0 — Neonatal cerebral ischemia, P91.1 — Acquired periventricular cysts of newborn, P91.2 — Neonatal cerebral leukomalacia, P91.3 — Neonatal cerebral irritability, P91.4 — Neonatal cerebral depression, P91.5 — Neonatal coma, P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified, P91.61 — Mild hypoxic ischemic encephalopathy [HIE], P91.62 — Moderate hypoxic ischemic encephalopathy [HIE], P91.63 — Severe hypoxic ischemic encephalopathy [HIE], P91.811 — Neonatal encephalopathy in diseases classified elsewhere, P91.819 — Neonatal encephalopathy, unspecified, P91.88 — Other specified disturbances of cerebral status of newborn, P91.9 — Disturbance of cerebral status of newborn, unspecified, R40.20 — Unspecified coma, R40.2110 — Coma scale, eyes open, never, unspecified time, R40.2111 — Coma scale, eyes open, never, in the field [EMT or ambulance], +40 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Major Head Injury with Loss of Consciousness > 1 Hour, Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified, Chronic Liver Failure/End-Stage Liver Disorders

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)).

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, G93.41 — Metabolic encephalopathy, G93.49 — Other encephalopathy, G93.5 — Compression of brain, 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, G95.11 — Acute infarction of spinal cord (embolic) (nonembolic), G95.19 — Other vascular myelopathies, G95.20 — Unspecified cord compression, +97 more

Same Index main term, other category

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

A15.7 — Primary respiratory tuberculosis (pleura, pleurisy, pleuritic, pleuropericardial, tuberculous NEC, primary), A81.1 — Subacute sclerosing panencephalitis (van Bogaert's), A81.2 — Progressive multifocal leukoencephalopathy (multifocal), D84.1 — Defects in the complement system (periodic, hereditary), E40 — Kwashiorkor (nutritional, with dyspigmentation, skin and hair), E75.25 — Metachromatic leukodystrophy (metachromatic), E87.0 — Hyperosmolality and hypernatremia (salt), E88.43 — Disorders of mitochondrial tRNA synthetases (with, thalamus - brainstem involvement - high lactate), G04.02 — Postimmunization acute disseminated encephalitis, myelitis and encephalomyelitis (postimmunization and postvaccinal), G92.8 — Other toxic encephalopathy (heroin vapor), G95.19 — Other vascular myelopathies (spinal), H02.841 — Edema of right upper eyelid (eyelid NEC, right, upper), H02.842 — Edema of right lower eyelid (eyelid NEC, right, lower), H02.843 — Edema of right eye, unspecified eyelid (eyelid NEC, right), H02.844 — Edema of left upper eyelid (eyelid NEC, left, upper), H02.845 — Edema of left lower eyelid (eyelid NEC, left, lower), H02.846 — Edema of left eye, unspecified eyelid (eyelid NEC, left), H02.849 — Edema of unspecified eye, unspecified eyelid (eyelid NEC), H05.22 — Edema of orbit (orbit), H11.42 — Conjunctival edema (conjunctiva), +62 more

Contextual Map

Every relationship of G93.6 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 G93.6 with these 4 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 202 — Coma, Brain Compression/Anoxic Damage [CMS-HCC]— CMS-HCC V28 · 2026

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).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
  • DRG 080 — NONTRAUMATIC STUPOR AND COMA WITH MCC[MS-DRG]: “NONTRAUMATIC STUPOR AND COMA WITH MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
  • DRG 081 — NONTRAUMATIC STUPOR AND COMA WITHOUT MCC[MS-DRG]: “NONTRAUMATIC STUPOR AND COMA WITHOUT MCC (MDC 01)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

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

  • Edema, edematous (infectious) (pitting) (toxic), brain (cytotoxic) (vasogenic)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Edema, edematous (infectious) (pitting) (toxic), intracranial[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Effusion, brain (serous)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Effusion, cerebral[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Effusion, cerebrospinal, vessel[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Effusion, intracranial[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Leukoencephalopathy, reversible, posterior[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (23)

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. "G93.6 — Cerebral edema." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/g93.6-cerebral-edema

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cerebral edema

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 G93.6 in its code family, with their registry titles.

View all codes in the G93 family