G00.1 ICD-10-CM Code: Pneumococcal meningitis
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Inflammatory diseases of the central nervous system (G00-G09)
G00.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePneumococcal meningitis
This is a serious bacterial infection of the membranes surrounding the brain and spinal cord caused by pneumococcal bacteria. It requires immediate medical treatment and can cause fever, severe headache, and stiff neck.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Meningitis due to Streptococcal pneumoniae
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for G00.1 in this effective period.
Related Child Codes
Includes
Official- bacterial arachnoiditis
- bacterial leptomeningitis
- bacterial meningitis
- bacterial pachymeningitis
Excludes 1
Official- bacterial meningoencephalitis (G04.2)
- bacterial meningomyelitis (G04.2)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for G00.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for G00.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for G00.1 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is G00.1 an HCC code?
No. G00.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
G00.1 is the ICD-10-CM diagnosis code for pneumococcal meningitis. This is a serious bacterial infection of the membranes surrounding the brain and spinal cord caused by pneumococcal bacteria. It requires immediate medical treatment and can cause fever, severe headache, and stiff neck. G00.1 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering inflammatory diseases of the central nervous system (g00-g09).
G00.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Ensure the documentation specifically identifies pneumococcal meningitis rather than other types of bacterial meningitis, as the causative organism is essential for accurate coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G00.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure the documentation specifically identifies pneumococcal meningitis rather than other types of bacterial meningitis, as the causative organism is essential for accurate coding
- •This code should be paired with appropriate severity indicators and any complications (such as sepsis) that may be documented, using additional codes as needed