G03.9 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupG03.9

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Inflammatory diseases of the central nervous system (G00-G09)

G03.9

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Meningitis, unspecified

Inflammation of the membranes surrounding the brain and spinal cord when the specific cause has not been identified or documented.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 004

HHS-HCC 004 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

G03Meningitis due to other and unspecified causes G03.9Meningitis, unspecified

Inclusion Terms

Official

Arachnoiditis (spinal) NOS

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from G00-G99
certain infectious and parasitic diseases (A00-B99)Inherited from G00-G99
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from G00-G99
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from G00-G99
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from G00-G99
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from G00-G99
neoplasms (C00-D49)Inherited from G00-G99
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from G00-G99

Related Codes

Official

G03.0Nonpyogenic meningitis G03.1Chronic meningitis G03.2Benign recurrent meningitis [Mollaret]G03.8Meningitis due to other specified causes

Includes

Official

arachnoiditis NOSInherited from G03
leptomeningitis NOSInherited from G03
meningitis NOSInherited from G03
pachymeningitis NOSInherited from G03

Excludes 1

Official

meningoencephalitis (G04.-)Inherited from G03
meningomyelitis (G04.-)Inherited from G03

Code First

Official

No Code First sequencing instructions are included in this display for G03.9. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for G03.9. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for G03.9. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Use this code only when the cause is truly unknown after appropriate workup

Query the provider if additional diagnostic testing results are available that would specify the cause

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is G03.9 an HCC code?

Code: G03.9
Description: Meningitis, unspecified
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

G03.9 is the ICD-10-CM diagnosis code for meningitis, unspecified. Inflammation of the membranes surrounding the brain and spinal cord when the specific cause has not been identified or documented. G03.9 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).

G03.9 has no mapping under the current CMS-HCC V28 community payment model. G03.9 also appears in the HHS-HCC commercial risk model (HCC 004 (HHS-HCC 004 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

Use this code only when the cause is truly unknown after appropriate workup.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for G03.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the cause is truly unknown after appropriate workup
•Query the provider if additional diagnostic testing results are available that would specify the cause