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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 076-viral-meningitis-without-cc-mcc
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    Viral Meningitis without CC/MCC: Inpatient Reimbursement Overview

    DRG 076 covers inpatient admissions for viral meningitis without Major Complication or Comorbidity and without Complication or Comorbidity; it defines the clinical population of uncomplicated viral meningitis that is reimbursed under a single bundled payment. Correct assignment to this Diagnosis-Related Group is important because it determines the Medicare inpatient reimbursement level tied to average resource consumption for these cases.

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    DRG 076 Overview

    DRG 076 covers hospital stays for patients primarily treated for viral meningitis without Major Complication or Comorbidity and without Complication or Comorbidity. This Diagnosis-Related Group applies when the principal diagnosis is a viral infection of the meninges managed medically, often requiring diagnostic lumbar puncture, neuroimaging, antiviral therapy when indicated, and supportive care. It matters for Medicare payment because cases classified to this Diagnosis-Related Group are assigned a bundled inpatient reimbursement rate based on average resource use for uncomplicated viral meningitis. Accurate clinical coding and documentation determine assignment to this Diagnosis-Related Group and thus the applicable Medicare inpatient payment.

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    Clinical Trials

    • Acute antiviral and supportive care timing studies: randomized or pragmatic trials evaluating the impact of early antiviral therapy, optimized hydration, and adjunctive symptomatic treatments in hospitalized adults and pediatric patients presenting with confirmed viral meningitis. These studies focus on time-to-treatment, route and intensity of supportive care, and short-term clinical endpoints such as time to symptom resolution, length of stay, and need for escalation to intensive monitoring. Results are directly relevant for providers to standardize in-hospital management and for payers seeking to reduce unnecessary variation in resource use and length of stay for cases captured under this DRG.
    • Comparative effectiveness and diagnostic stewardship studies: prospective cohort or cluster-randomized studies comparing diagnostic algorithms (e.g., rapid molecular CSF testing versus stepwise testing with empiric inpatient management) and care pathways (observation-only versus short-course empiric therapies) in patients with suspected viral meningitis. These trials enroll patients undergoing lumbar puncture and aim to measure diagnostic yield, antibiotic/antiviral utilization, antibiotic stewardship metrics, hospital length of stay, and readmission rates. Findings help hospitals and payers optimize testing strategies to avoid unnecessary treatments and admissions while maintaining patient safety and appropriate use of reimbursement resources.
    • Post-discharge functional outcomes and health economics studies: longitudinal observational or registry-based studies tracking cognitive, neuropsychological, and quality-of-life outcomes, return-to-work/school timelines, and health care utilization among patients discharged with a primary diagnosis of viral meningitis. These studies assess prolonged morbidity, outpatient rehabilitative needs, and downstream costs (clinic visits, imaging, medication use) over weeks to months after hospitalization. The evidence informs postacute care planning, discharge criteria, and payer decisions about coverage for follow-up services and rehabilitation to minimize long-term disability and total cost of care for this DRG.

    Related Codes

    020-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITH-MCC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with MCC: Inpatient Reimbursement Overview

    021-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITH-CC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with CC: Inpatient Reimbursement Overview

    022-INTRACRANIAL-VASCULAR-PROCEDURES-WITH-PRINCIPAL-DIAGNOSIS-HEMORRHAGE-WITHOUT-CC-MCC

    Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage without CC/MCC: Inpatient Reimbursement Overview

    023-CRANIOTOMY-WITH-MAJOR-DEVICE-IMPLANT-OR-ACUTE-COMPLEX-CNS-PRINCIPAL-DIAGNOSIS-WITH-MCC-OR-ANTINEOPLASTIC-IMPLANT-OR-EPILEPSY-WITH-NEUROSTIMULATOR

    Craniotomy with Major Device Implant or Complex CNS DRG 023: Inpatient Reimbursement Overview

    024-CRANIOTOMY-WITH-MAJOR-DEVICE-IMPLANT-OR-ACUTE-COMPLEX-CNS-PRINCIPAL-DIAGNOSIS-WITHOUT-MCC

    Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCC: Inpatient Reimbursement Overview

    025-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITH-MCC

    Craniotomy and Endovascular Intracranial Procedures with MCC: Inpatient Reimbursement Overview

    026-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITH-CC

    Craniotomy and Endovascular Intracranial Procedures with CC: Inpatient Reimbursement Overview

    027-CRANIOTOMY-AND-ENDOVASCULAR-INTRACRANIAL-PROCEDURES-WITHOUT-CC-MCC

    Craniotomy and Endovascular Intracranial Procedures without CC/MCC: Inpatient Reimbursement Overview

    028-SPINAL-PROCEDURES-WITH-MCC

    Spinal Procedures with MCC: Inpatient Reimbursement Overview

    029-SPINAL-PROCEDURES-WITH-CC-OR-SPINAL-NEUROSTIMULATORS

    Spinal Procedures with CC or Spinal Neurostimulators: Inpatient Reimbursement Overview

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    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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