G04.2 — Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified
Is G04.2 billable?
Yes, but G04.2 is an unspecified code. G04.2 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, G04.2 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting G04.2 — the more specific alternatives are listed below.
G04.2 at a glance
| Code | G04.2 |
|---|---|
| Description | Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does G04.2 group to?
G04.2 sits in MDC 01 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 023Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis with MCC or Antineoplastic Implant or Epilepsy with Neurostimulatorsurgical
- 024Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCCsurgical
As a secondary diagnosis, G04.2 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is G04.2 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to G04.2. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Meningoencephalitis › bacterial NEC
- Meningoencephalitis › pneumococcal
- Meningoencephalitis › staphylococcal
- Meningoencephalitis › streptococcal
- Meningomyelitis › bacterial NEC
Excludes1 — never code together — inherited from G04
The conditions below can never be reported together with G04.2 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- encephalopathy NOS (G93.40)
Excludes2 — not included here — inherited from Chapter 6
The conditions below are not part of G04.2, but a patient may have both at the same time. When documentation supports it, G04.2 and the excluded code may both 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)
Excludes2 — not included here — inherited from G04
The conditions below are not part of G04.2, but a patient may have both at the same time. When documentation supports it, G04.2 and the excluded code may both be reported.
How long has G04.2 existed?
G04.2 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
Which codes are confused with G04.2?
ICD-10-CM declares these codes mutually exclusive with G04.2 — exactly one of each pair can be correct for a given encounter.
Which conditions are coded to G04.2?
What other codes are in the G04 family? (5)
- G04.0Acute disseminated encephalitis and encephalomyelitis (ADEM)not billable
- G04.1Tropical spastic paraplegia
- G04.3Acute necrotizing hemorrhagic encephalopathynot billable
- G04.8Other encephalitis, myelitis and encephalomyelitisnot billable
- G04.9Encephalitis, myelitis and encephalomyelitis, unspecifiednot billable