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v1.0.0
ICD-10 Guide
ICD-10 CodesG04.2

G04.2

Billable

Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified

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

Code Description

ICD-10 G04.2 is a billable code used to indicate a diagnosis of bacterial meningoencephalitis and meningomyelitis, not elsewhere classified.

Key Diagnostic Point:

Bacterial meningoencephalitis and meningomyelitis represent severe central nervous system (CNS) infections characterized by inflammation of both the meninges and the brain or spinal cord. This condition can arise from various bacterial pathogens, including Streptococcus pneumoniae, Neisseria meningitidis, and Listeria monocytogenes, among others. Clinically, patients may present with symptoms such as fever, headache, neck stiffness, altered mental status, and neurological deficits. Diagnosis typically involves lumbar puncture for cerebrospinal fluid (CSF) analysis, which may reveal elevated white blood cell counts, elevated protein levels, and decreased glucose levels. Imaging studies, such as CT or MRI, may be utilized to assess for complications like brain abscesses or edema. Treatment usually involves prompt initiation of intravenous antibiotics and supportive care. The condition can lead to significant morbidity and mortality if not recognized and treated swiftly, making accurate coding essential for appropriate management and resource allocation.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of potential causative organisms requiring precise identification.
  • Overlap with other CNS infections, necessitating careful differentiation.
  • Potential for severe complications, which may affect coding specificity.
  • Need for comprehensive documentation of clinical findings and treatment.

Audit Risk Factors

  • Inadequate documentation of causative organism.
  • Failure to document clinical symptoms and neurological findings.
  • Misclassification of the type of CNS infection.
  • Lack of clarity in treatment protocols followed.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with fever, altered mental status, and neurological deficits.

Billing Considerations

Ensure all clinical findings are documented to support the diagnosis and treatment plan.

Infectious Disease

Documentation Requirements

Identification of the specific bacterial pathogen and treatment response.

Common Clinical Scenarios

Patients with suspected bacterial CNS infections requiring specialized management.

Billing Considerations

Document antibiotic therapy and any changes in clinical status.

Coding Guidelines

Inclusion Criteria

Use G04.2 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the clinical presentation, causative organism, and any complications
  • Include relevant laboratory and imaging results to support the diagnosis

Exclusion Criteria

Do NOT use G04.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to obtain CSF for analysis in suspected cases of meningoencephalitis.

Documentation Requirements

Document indication for the procedure, patient consent, and any complications.

Specialty Considerations

Neurology specialists should ensure thorough documentation of neurological assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of bacterial meningoencephalitis, improving data accuracy and facilitating better patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of bacterial meningoencephalitis, improving data accuracy and facilitating better patient management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of bacterial meningoencephalitis, improving data accuracy and facilitating better patient management and research.

Resources

Clinical References

  • •
    CDC - Meningitis

Coding & Billing References

  • •
    CDC - Meningitis

Frequently Asked Questions

What are the common symptoms of bacterial meningoencephalitis?

Common symptoms include fever, severe headache, neck stiffness, altered mental status, and neurological deficits. Prompt recognition is crucial for effective treatment.