2027 ICD-10-CM Diagnosis Code G04.2Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified
ICD-10-CM Codes›G00–G99›G00-G09›G04
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
G04.2 is a billable ICD-10-CM diagnosis code for bacterial meningoencephalitis and meningomyelitis, not elsewhere classified. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 23 through 24, 94 through 96, 791, 793. 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 106 closely related codes. Coders also document this condition as bacterial meningoencephalitis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Bacterial infections and Encephalitis.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Bacterial meningoencephalitis
- Bacterial meningomyelitis
- Meningomyelitis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to G04.2: its own notes plus those printed at G04 and Chapter 6. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- acute ascending myelitis
- meningoencephalitis
- meningomyelitis
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
- 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 G04.2, its category, or a range that includes it.
Excludes1 4
These codes carry an Excludes1 note naming G04.2: they are not reported together with it, unless the two conditions are unrelated.
- G00 Bacterial meningitis, not elsewhere classifiedbacterial meningoencephalitis (G04.2)
- G00 Bacterial meningitis, not elsewhere classifiedbacterial meningomyelitis (G04.2)
- G03 Meningitis due to other and unspecified causesmeningoencephalitis (G04.-) names G04.-, which includes this code
- G03 Meningitis due to other and unspecified causesmeningomyelitis (G04.-) names G04.-, which includes this code
Excludes2 1
These codes carry an Excludes2 note naming G04.2: its condition is not part of those codes, and both may be reported when the patient has both.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Meningoencephalitis See Also: Encephalitis; G04.90
bacterial NEC G04.2
pneumococcal G04.2
staphylococcal G04.2
streptococcal G04.2
Meningomyelitis See Also: Meningoencephalitis;
bacterial NEC G04.2
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Encephalitis
Encephalitis is inflammation (swelling) of the brain. It can happen when an infection or medical condition that affects the brain activates your immune system. The inflammation can cause a wide range of symptoms. In extreme cases, it can lead to brain damage, stroke, or even death.
The full article covers:
- What is encephalitis?
- What causes encephalitis?
- Who is more likely to get encephalitis?
- What are the symptoms of encephalitis?
- How is encephalitis diagnosed?
- What are the treatments for encephalitis?
- Can encephalitis be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert G04.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About G04.2Overview
Is G04.2 (Encephalitis, myelitis and encephalomyelitis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report bacterial meningoencephalitis and meningomyelitis, not elsewhere classified on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does G04.2 group to?
When bacterial meningoencephalitis and meningomyelitis, not elsewhere classified is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 24, 23, 96, 95, 94, with relative weights from 2.3173 to 5.7422 depending on complications. Higher weights mean higher Medicare reimbursement.
Is G04.2 a CC or MCC?
CMS lists G04.2 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 106 closely related codes in its exclusion list.
Can G04.2 be reported with G93.40?
Not as a rule. The Excludes1 note at G04, which applies to G04.2, lists "encephalopathy NOS (G93.40)". 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 is the ICD-9 equivalent of G04.2?
Under the General Equivalence Mappings, bacterial meningoencephalitis and meningomyelitis, not elsewhere classified converts to ICD-9-CM 320.9 (bacterial meningitis NOS). The mapping is approximate, so confirm the match fits the documentation.