ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 G03.9

Billable / Specific MCC

Meningitis, unspecified

G03
Block
1
Synonyms
572
LCDs
11
Payer Policies
0
Linked CPTs

About ICD-10-CM G03.9

ICD-10-CM code G03.9 represents Meningitis, unspecified. This is a billable/specific code in the Nervous System chapter (block G03). The 2026 edition of ICD-10-CM G03.9 became effective on October 1, 2025.

Coding Tips for G03.9

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: MCC

G03.9 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under G03.9. Per CMS ICD-10-CM Tabular 2026.

  • Arachnoiditis (spinal) NOS

Inpatient DRG Impact, MCC

codes Meningitis, unspecified. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for G03.9

Local Coverage Determinations (LCDs) from CMS MACs that list G03.9 as a covered diagnosis.

572 LCDs

Showing top 10 of 572 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87555 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87653 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87486 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87626 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 0109U →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87516 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87517 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87528 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87476 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87594 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G03.9.

11 policies

3 Aetna

Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0094
Spinal Cord Stimulation
Policy ID: CPB-0194
Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) of the Spine
Policy ID: CPB-0236

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

5 Medicare

Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Implantable Infusion Pump
Policy ID: ART-56695
Billing and Coding: Visual Fields Testing
Policy ID: ART-56799
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58710
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Policy ID: ART-58720

CPT Codes Commonly Billed with G03.9

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for G03.9

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert G03.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
G03.9 3229 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 G03.9, Billing FAQ

Is ICD-10 code G03.9 billable? +

Yes, G03.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to G03.9? +

ICD-10 G03.9 includes: Arachnoiditis (spinal) NOS.

Is G03.9 a CC or MCC for inpatient DRG? +

Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does G03.9 map to? +

Per CMS GEMs, G03.9 maps to ICD-9 codes: 3229. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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