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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 095-bacterial-and-tuberculous-infections-of-nervous-system-with-cc
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    Bacterial and Tuberculous Infections of Nervous System with CC: Inpatient Reimbursement Overview

    DRG 095 addresses bacterial and tuberculous infections of the nervous system with a Complication or Comorbidity, encompassing conditions like bacterial meningitis and tuberculous meningitis with additional complicating diagnoses. It matters for inpatient reimbursement because the presence of a Complication or Comorbidity increases relative resource use and thereby affects Medicare hospital payment under the Diagnosis-Related Group system.

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    DRG 095 Overview

    DRG 095 covers hospital admissions for bacterial and tuberculous infections of the nervous system when a Complication or Comorbidity is present. This includes conditions such as bacterial meningitis, intracranial abscesses, and tuberculous meningitis with coexisting complications that increase resource use. The Diagnosis-Related Group classification influences reimbursement by grouping clinically similar cases with comparable expected costs for Medicare payment. Accurate coding of the infection type and coexisting Complication or Comorbidity affects payment assignment under inpatient prospective payment.

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    Clinical Trials

    • Acute antimicrobial regimen optimization trials: randomized or adaptive studies comparing durations, routes (IV vs IV-to-oral switch), and combinations of antibiotics in adults hospitalized with bacterial or tuberculous central nervous system (CNS) infections (e.g., bacterial meningitis, tuberculoma, tuberculous meningitis). These trials enroll patients during the index hospitalization with confirmed or highly suspected CNS infection to determine the shortest effective therapy and best step-down strategies while monitoring relapse, neurologic complications, and adverse events. Findings directly inform inpatient length of stay, antibiotic utilization, and readmission risk — key drivers of cost and resource use for providers and payers managing DRG 095 patients.
    • Adjunctive therapies and supportive care intervention studies: controlled trials evaluating non-antimicrobial interventions given during acute care, such as corticosteroid timing/dosing strategies, intracranial pressure management protocols, or rapid diagnostic-guided treatment algorithms for severe bacterial or tuberculous CNS infections. These studies typically recruit critically ill inpatients with altered mental status or raised intracranial pressure to assess impact on neurologic outcomes, mortality, need for ICU-level care, and complication rates (hydrocephalus, infarcts). Results are relevant to clinicians and payers because improvements in acute neurologic outcomes and reductions in ICU days or neurosurgical interventions can lower costs and improve DRG-level resource allocation.
    • Post-discharge functional outcomes and health services research: prospective cohort studies and comparative effectiveness research following survivors of CNS bacterial or tuberculous infections after hospital discharge to measure long-term neurologic disability, cognitive impairment, rehospitalization, and outpatient service utilization. These studies focus on diverse populations including older adults, patients with HIV or immunosuppression, and those with prolonged inpatient stays, assessing rehabilitation needs, adherence to prolonged therapy (especially for tuberculous CNS disease), and predictors of readmission. Payers and health systems use these data to plan post-acute care, allocate rehabilitation resources, design follow-up protocols to reduce costly readmissions, and evaluate bundled payment or care pathway effectiveness for DRG 095.

    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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