2027 ICD-10-CM Diagnosis Code G93.6Cerebral edema

ICD-10-CM Codes›G00–G99›G89-G99›G93

ICD-10-CM G93.6
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

G93.6 is a billable ICD-10-CM diagnosis code for cerebral edema. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 80 through 81. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 2 closely related codes. Coders also document this condition as cerebellar edema. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other nervous system disorders (neither hereditary nor degenerative).

For Medicare Advantage risk adjustment, G93.6 maps to CMS-HCC Category 202 (Coma, Brain Compression/Anoxic Damage) under the V28 model, adding a risk factor of about 0.543 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
G93.6
Billable Status
Yes — Valid for Submission
Code Describes
Cerebral edema
Short Description
Cerebral edema
Same as the full description in the CMS dataset.
Parent Code
G93
Other disorders of brain

Code Classification

ChapterG00–G99Diseases of the nervous system
SectionG89-G99Other disorders of the nervous system
CategoryG93Other disorders of brain
This CodeG93.6Cerebral edema

Medicare Risk Adjustment (HCC)Billing

G93.6 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 202— Coma, Brain Compression/Anoxic Damage
Payment HCC · PY 2027 one of 61 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.543
community, non-dual, aged · ranges 0.097–0.721 across segments
Hierarchy
Superseded by HCC 63, HCC 397, and HCC 398
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 80
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 80 · ESRD (V21): HCC 80 · ESRD (V24): HCC 80
ESRD V21 weights: 0.043 dialysis, 0.000–0.184 functioning graft · ESRD V24 weights: 0.076 dialysis, 0.063–0.679 functioning graft
Part D (RxHCC)
Not mapped
G93.6 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Cerebellar edema
  • Cerebral edema
  • Cytotoxic cerebral edema
  • Effects of high altitude
  • High altitude cerebral edema
  • Nontraumatic cerebellar edema
  • Non-traumatic cerebral edema
  • Periventricular cerebrospinal fluid edema
  • Vasogenic cerebral edema

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to G93.6: its own notes plus those printed at Chapter 6. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • cerebral edema due to birth injury (P11.0)
  • traumatic cerebral edema (S06.1-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 6 (G00-G99) Diseases of the nervous system applies to 700 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name G93.6, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming G93.6: they are not reported together with it, unless the two conditions are unrelated.

  • R60 Edema, not elsewhere classified
    cerebral edema (G93.6)

Code Also 1

These codes say G93.6 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • G92.0 Immune effector cell-associated neurotoxicity syndrome
    cerebral edema (G93.6)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NVS020
Other nervous system disorders (neither hereditary nor degenerative)
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Cerebral Edema

    swelling due to an excessive accumulation of fluid in the brain.

Patient EducationClinical

Brain Diseases

Your brain is the control center of your body. It controls your thoughts, memory, speech, and movement. It regulates the function of many organs. It's part of your nervous system, which also includes your spinal cord and peripheral nerves. The nervous system sends signals between your brain and the rest of the body.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert G93.6 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
348.5 Cerebral edema
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About G93.6Overview

What is the ICD-10 code for cerebral edema?

The ICD-10-CM code for cerebral edema is G93.6 (sometimes written as G936). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is G93.6 (Other disorders of brain) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report cerebral edema on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does G93.6 group to?

When cerebral edema is the principal diagnosis on an inpatient stay, it groups to MS-DRG 81, 80, with relative weights from 0.7941 to 1.7476 depending on complications. Higher weights mean higher Medicare reimbursement.

Is G93.6 a CC or MCC?

CMS lists G93.6 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 2 closely related codes in its exclusion list.

Can G93.6 be reported with P11.0?

Not as a rule. The Excludes1 note on G93.6 lists "cerebral edema due to birth injury (P11.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is G93.6?

G93.6 (cerebral edema) maps to CMS-HCC Category 202 (Coma, Brain Compression/Anoxic Damage), commonly written as HCC 202, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 80 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does G93.6 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, G93.6 adds a risk adjustment factor of about 0.543 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.097 to 0.721 depending on the payment segment). A more severe related category (HCC 63, HCC 397, and HCC 398) supersedes it when both are reported. See the full factor table on the HCC 202 category page.