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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG03

G03

Billable

Meningitis due to other and unspecified causes

Chapter 6:Diseases of the nervous system

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G03 is a billable code used to indicate a diagnosis of meningitis due to other and unspecified causes.

Key Diagnostic Point:

Meningitis due to other and unspecified causes refers to inflammation of the protective membranes covering the brain and spinal cord, which is not attributed to known infectious agents such as bacteria, viruses, or fungi. This condition can arise from various etiologies, including autoimmune disorders, drug reactions, or post-infectious processes. Clinically, patients may present with symptoms such as fever, headache, neck stiffness, altered mental status, and photophobia. Diagnosis typically involves a lumbar puncture to analyze cerebrospinal fluid (CSF), which may show elevated white blood cell counts, protein levels, and decreased glucose levels, depending on the underlying cause. The management of G03 often requires a multidisciplinary approach, including neurologists, infectious disease specialists, and primary care providers, to identify the underlying cause and initiate appropriate treatment. Given the potential for severe complications, including neurological deficits and death, timely diagnosis and intervention are critical.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for comprehensive clinical documentation
  • Differentiation from other types of meningitis
  • Potential for co-existing conditions

Audit Risk Factors

  • Insufficient documentation of the underlying cause
  • Inconsistent clinical findings in the medical record
  • Failure to document the patient's clinical course
  • Lack of follow-up notes or treatment plans

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, CSF analysis results, and imaging studies.

Common Clinical Scenarios

Patients presenting with acute onset of headache, fever, and neck stiffness.

Billing Considerations

Ensure that all differential diagnoses are considered and documented.

Infectious Disease

Documentation Requirements

Comprehensive history of exposure, laboratory results, and treatment response.

Common Clinical Scenarios

Patients with a history of recent infections or immunocompromised status presenting with neurological symptoms.

Billing Considerations

Document any infectious workup performed to rule out specific pathogens.

Coding Guidelines

Inclusion Criteria

Use G03 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • G03 should be used when the cause of meningitis is not specified or is due to an unspecified infectious agent

Exclusion Criteria

Do NOT use G03 When
No specific exclusions found.

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to obtain CSF for analysis in suspected meningitis cases.

Documentation Requirements

Document indication for the procedure, consent, and results of CSF analysis.

Specialty Considerations

Neurology and infectious disease specialists should ensure thorough documentation of clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of meningitis cases, including those with unspecified causes. This has improved data accuracy and allowed for better tracking of epidemiological trends.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of meningitis cases, including those with unspecified causes. This has improved data accuracy and allowed for better tracking of epidemiological trends.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of meningitis cases, including those with unspecified causes. This has improved data accuracy and allowed for better tracking of epidemiological trends.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should G03 be used?

G03 should be used when meningitis is diagnosed but the specific cause is unknown or not specified. It is important to document the clinical findings and any tests performed to support this diagnosis.