B01.11

Varicella encephalitis and encephalomyelitis

FY2027Chapter 1: Certain infectious and parasitic diseases/B00–B09 Viral infections characterized by skin and mucous membrane lesions

BillableComplete code, valid to report

B01.11 (also written B0111) is a billable ICD-10-CM diagnosis code for varicella encephalitis and encephalomyelitis. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 7 codes in category B01 (Varicella [chickenpox]). The Alphabetic Index lists it under 6 entries. Its coding notes include a Use additional code instruction and 5 Excludes2 entries.

Use additional code

Add the listed code as a secondary code, if known.

Also from chapter/block level (1 note)
Inherited from Chapter 1 Certain infectious and parasitic diseases
  • code to identify resistance to antimicrobial drugs (Z16.-)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (5 notes)
Inherited from Chapter 1 Certain infectious and parasitic diseases
  • carrier or suspected carrier of infectious disease (Z22.-)
  • certain localized infections - see body system-related chapters
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)
  • influenza and other acute respiratory infections (J00-J22)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Neuro Rehabilitation clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

IRF 60% Rule

On the CMS list of diagnoses used to determine presumptive compliance with the IRF 60 percent rule.

Source: CMS IRF Presumptive Compliance-3, FY 2027 IRF PPS final rule files, effective for discharges on or after October 1, 2026

Hospital MCC

Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 24 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

Includes

Further defines or gives examples of the content of the category.

Also from chapter/block level (1 note)
Inherited from Chapter 1 Certain infectious and parasitic diseases
  • diseases generally recognized as communicable or transmissible

Inclusion terms

Conditions classified to this code.

This code
  • Postchickenpox encephalitis and encephalomyelitis

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 6 entries