2027 ICD-10-CM Diagnosis Code H81.4Vertigo of central origin

ICD-10-CM Codes›H60–H95›H80-H83›H81

ICD-10-CM H81.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

H81.4 is a billable ICD-10-CM diagnosis code for vertigo of central origin. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 149. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Diseases of inner ear and related conditions.

Code Identity

ICD-10-CM Code
H81.4
Billable Status
Yes — Valid for Submission
Code Describes
Vertigo of central origin
Short Description
Vertigo of central origin
Same as the full description in the CMS dataset.
Parent Code
H81
Disorders of vestibular function

Code Classification

ChapterH60–H95Diseases of the ear and mastoid process
SectionH80-H83Diseases of inner ear
CategoryH81Disorders of vestibular function
This CodeH81.4Vertigo of central origin

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Brain stem vertigo
  • Central positional nystagmus
  • Central positional vertigo
  • Cerebellar vertigo
  • Cortical vertigo
  • Downbeat nystagmus
  • Fatigable positional nystagmus
  • Malignant positional vertigo
  • Neck positional nystagmus
  • Non-fatigable positional nystagmus
  • Positional nystagmus
  • Vertical nystagmus
  • Vertigo as late effect of stroke
  • Vertigo as sequela of cerebrovascular disease
  • Vertigo due to brain injury
  • Vertigo of central origin

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to H81.4: its own notes plus those printed at H81 and Chapter 8. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Central positional nystagmus

Excludes1

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

From H81 Disorders of vestibular function applies to 29 codes
  • epidemic vertigo (A88.1)
  • vertigo NOS (R42)

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 8 (H60-H95) Diseases of the ear and mastoid process applies to 653 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)

Notes

General instructions on how these codes are used.

From Chapter 8 (H60-H95) Diseases of the ear and mastoid process applies to 653 codes
  • Use an external cause code following the code for the ear condition, if applicable, to identify the cause of the ear condition

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name H81.4, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming H81.4: they are not reported together with it, unless the two conditions are unrelated.

  • R42 Dizziness and giddiness
    vertiginous syndromes (H81.-) names H81.-, which includes this code

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 EAR003
Diseases of inner ear and related conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Dizziness and Vertigo

Dizziness and vertigo are not the same thing, but they are often mixed up.

The full article covers:

  • What is dizziness and vertigo?
  • What causes dizziness and vertigo?
  • How is the cause of dizziness and vertigo diagnosed?
  • What are the treatments for dizziness and vertigo?

Read the full article at MedlinePlus

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

Code History & ChangesHistory

Replacement H81.4 replaces the following previously assigned code(s):

  • H81.49 - Vertigo of central origin, unspecified ear
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 H81.4Overview

What is the ICD-10 code for vertigo of central origin?

The ICD-10-CM code for vertigo of central origin is H81.4 (sometimes written as H814). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is H81.4 (Disorders of vestibular function) a billable code?

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

What MS-DRG does H81.4 group to?

When vertigo of central origin is the principal diagnosis on an inpatient stay, it groups to MS-DRG 149 (dysequilibrium), which carries a relative weight of 0.7526. Higher weights mean higher Medicare reimbursement.

Can H81.4 be reported with A88.1?

Not as a rule. The Excludes1 note at H81, which applies to H81.4, lists "epidemic vertigo (A88.1)". 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).