A85.8: Other specified viral encephalitis
A85.8, other specified viral encephalitis, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 26 HCPCS Level II codes, including U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19)…), U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr…), J1569 (Injection, immune globulin, (gammagard liquid/gammagard…). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with A85.8 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | Carrier judgment | — | 4 |
| U0001 | Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel | Carrier judgment | — | 4 |
| J1569 | Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg | Special coverage instructions apply | — | 1 |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1576 | Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1556 | Injection, immune globulin (bivigam), 500 mg | Carrier judgment | — | 1 |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | Special coverage instructions apply | — | 1 |
| J1554 | Injection, immune globulin (asceniv), 500 mg | Carrier judgment | — | 1 |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | Carrier judgment | — | 1 |
| J2791 | Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu | Special coverage instructions apply | — | 1 |
| J1552 | Injection, immune globulin (alyglo), 500 mg | Carrier judgment | — | 1 |
| J2792 | Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu | Special coverage instructions apply | — | 1 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior | Carrier judgment | — | 1 |
1 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing A85.8
- A56718: Billing and Coding: Intravenous Immunoglobulin (IVIG) (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L34580
- A58710: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A58720: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A58761: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A58747: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other A85 diagnoses (Other viral encephalitis, not elsewhere classified)
- A85.0 — Enteroviral encephalitis
- A85.1 — Adenoviral encephalitis
- A85.2 — Arthropod-borne viral encephalitis, unspecified
Frequently asked questions
Does Medicare cover A85.8 (Other specified viral encephalitis)?
Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list A85.8 as a covered diagnosis for 26 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 A85.8?
The Level II codes from the policies most specific to this diagnosis are U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19)…, 4 articles); U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr…, 4 articles); J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 1 article); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 1 article); J1459 (Injection, immune globulin (privigen), intravenous…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list A85.8?
A56718 (Billing and Coding: Intravenous Immunoglobulin (IVIG)); A58710 (Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing); A58720 (Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing), and 4 more articles.
What is ICD-10-CM code A85.8?
A85.8 is the ICD-10-CM code for other specified viral encephalitis, in category A85 (Other viral encephalitis, not elsewhere classified), chapter 1: Certain infectious and parasitic diseases.
Next steps
- Run a reimbursement report for a device billed under U0002
- Watch U0002 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for U0002
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 1: Certain infectious and parasitic diseases · All diagnoses · HCPCS lookup