2021 ICD-10-CM Code B94.1

Sequelae of viral encephalitis

Version 2021
Billable Code
Sequela Code
POA Exempt

Valid for Submission

B94.1 is a billable diagnosis code used to specify a medical diagnosis of sequelae of viral encephalitis. The code B94.1 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.

The ICD-10-CM code B94.1 might also be used to specify conditions or terms like late effects of viral encephalitis. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

B94.1 is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like e of viral encephalitis. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

ICD-10:B94.1
Short Description:Sequelae of viral encephalitis
Long Description:Sequelae of viral encephalitis

Code Classification

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code B94.1 are found in the index:

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Present on Admission (POA)

B94.1 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert B94.1 to ICD-9 Code

Information for Patients


Encephalitis

Encephalitis is an inflammation of the brain. Usually the cause is a viral infection, but bacteria can also cause it. It can be mild or severe. Most cases are mild. You may have flu-like symptoms. With a mild case, you may just need rest, plenty of fluids, and a pain reliever.

Severe cases need immediate treatment. Symptoms of severe cases include

In babies, additional symptoms may include constant crying, poor feeding, body stiffness, and bulging in the soft spots of the skull.

Severe cases may require a stay in the hospital. Treatments include oral and intravenous (IV) medicines to reduce inflammation and treat infection. Patients with breathing difficulties may need artificial respiration. Some people may need physical, speech, and occupational therapy once the illness is under control.

NIH: National Institute of Neurological Disorders and Stroke


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Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)