G04.2

Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified

FY2027Chapter 6: Diseases of the nervous system/G00–G09 Inflammatory diseases of the central nervous system

BillableComplete code, valid to report

G04.2 (also written G042) is a billable ICD-10-CM diagnosis code for bacterial meningoencephalitis and meningomyelitis, not elsewhere classified. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 14 codes in category G04 (Encephalitis, myelitis and encephalomyelitis). The Alphabetic Index lists it under 5 entries. Its coding notes include 1 Excludes1 entry and 15 Excludes2 entries.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from G04 Encephalitis, myelitis and encephalomyelitis

Excludes2

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

Inherited from G04 Encephalitis, myelitis and encephalomyelitis
  • acute transverse myelitis (G37.3)
  • alcoholic encephalopathy (G31.2)
  • multiple sclerosis (G35-)
  • myalgic encephalomyelitis (G93.32)
  • subacute necrotizing myelitis (G37.4)
  • toxic encephalitis (G92.8)
  • toxic encephalopathy (G92.8)
Also from chapter/block level (8 notes)
Inherited from Chapter 6 Diseases of the nervous system
  • 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)

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 106 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.

Inherited from G04 Encephalitis, myelitis and encephalomyelitis
  • acute ascending myelitis
  • meningoencephalitis
  • meningomyelitis

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 5 entries