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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 096-bacterial-and-tuberculous-infections-of-nervous-system-without-cc-mcc
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    Bacterial and Tuberculous Infections of Nervous System without CC/MCC: Inpatient Reimbursement Overview

    DRG 096 addresses bacterial and tuberculous infections of the nervous system without Major Complication or Comorbidity or Complication or Comorbidity; it encompasses conditions like bacterial meningitis and central nervous system tuberculosis when no higher-severity comorbidities are coded. Accurate classification matters for inpatient reimbursement because the Diagnosis-Related Group assignment drives Medicare payment levels based on expected resource consumption.

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    DRG 096 Overview

    DRG 096 covers inpatient stays for bacterial and tuberculous infections of the nervous system without a Major Complication or Comorbidity and without a Complication or Comorbidity. This group includes diagnoses such as bacterial meningitis and central nervous system tuberculosis when no higher-severity comorbid conditions are present. It matters for Medicare payment because the assigned Diagnosis-Related Group determines reimbursement rates tied to average resource use for these infectious neurologic conditions. Appropriate coding of primary diagnosis and comorbid conditions is essential to ensure correct Medicare Severity Diagnosis-Related Group assignment and payment.

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    Clinical Trials

    • Acute antimicrobial regimen trials: randomized or adaptive studies comparing different antibiotic or anti-tuberculous treatment strategies (duration, dosing strategies, or route of administration) in adults and children hospitalized with confirmed bacterial or tuberculous central nervous system infection without major comorbid complications. These studies focus on time to sterilization of cerebrospinal fluid, clinical neurological recovery, and in-hospital adverse events to define optimal inpatient antimicrobial approaches. Results directly inform inpatient length of stay, antibiotic utilization, and adverse event rates that drive hospital resource use and payer reimbursement for this DRG.
    • Comparative effectiveness and diagnostic strategy studies in early inpatient care: prospective cohort or pragmatic trials evaluating the impact of rapid diagnostics (molecular CSF tests, PCR panels, or biomarkers) and standardized care pathways versus usual care for patients presenting with suspected bacterial or tuberculous meningitis. The population includes patients admitted from emergency departments with suspected CNS infection but without major CC/MCC, aiming to determine effects on time-to-targeted therapy, unnecessary broad-spectrum antibiotic exposure, and early neurological outcomes. Findings affect clinical decision-making, antibiotic stewardship, and cost-efficiency metrics important to providers and payers managing inpatient episodes under this DRG.
    • Post-discharge outcomes and rehabilitation research: longitudinal observational studies and interventional trials evaluating neurologic, cognitive, and functional recovery trajectories and post-acute care needs among survivors of bacterial or tuberculous CNS infections who lacked major complications during hospitalization. These studies enroll patients at discharge and track readmissions, outpatient therapy utilization, disability, and quality-of-life over months to a year to identify predictors of poorer long-term outcomes and effective post-discharge interventions. For payers and hospitals, this research highlights drivers of downstream costs, readmission risk, and opportunities to optimize discharge planning and community services for this DRG cohort.

    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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