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    v1.0.28
    OpenPayerBilling CodesDiseases and Disorders of the Nervous SystemDRG 098-non-bacterial-infection-of-nervous-system-except-viral-meningitis-with-cc
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    Non-Bacterial Infection of Nervous System Except Viral Meningitis with CC: Inpatient Reimbursement Overview

    DRG 098 encompasses non-bacterial infections of the nervous system except viral meningitis when a Complication or Comorbidity is present, covering conditions that increase clinical complexity and resource use. Proper assignment to this Diagnosis-Related Group affects inpatient reimbursement under Centers for Medicare & Medicaid Services payment methodology because severity classification drives relative weight and payment.

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    DRG 098 Overview

    DRG 098 covers non-bacterial infections of the nervous system other than viral meningitis when a Complication or Comorbidity is present, such as viral encephalitis or fungal central nervous system infection with additional clinical complexity. This Diagnosis-Related Group groups patients with higher resource use than uncomplicated cases because the Complication or Comorbidity increases diagnostic, monitoring, and treatment needs. It matters for Medicare payment because assignment to this Diagnosis-Related Group affects inpatient prospective payment and hospital reimbursement under Centers for Medicare & Medicaid Services rules. Accurate coding and documentation determine whether a case is assigned to DRG 098 rather than to a lower-severity group.

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    Clinical Trials

    • Acute-management randomized or controlled trials examining adjunctive anti-inflammatory or immunomodulatory therapies in hospitalized patients diagnosed with non-bacterial central nervous system infections (excluding viral meningitis), focusing on patients with altered mental status, focal neurologic deficits, or intracranial complications. These studies enroll patients during the inpatient stay to evaluate short-term endpoints such as time to neurologic stabilization, need for ICU-level care, length of stay, and in-hospital complication rates. Results inform clinicians about interventions that could shorten acute resource use and help payers anticipate and manage high-cost episodes of care associated with complicated CNS infections with comorbid conditions.
    • Comparative effectiveness and diagnostic-optimization studies that assess different combinations of imaging strategies, cerebrospinal fluid testing algorithms, and antimicrobial stewardship approaches in adults presenting with suspected non-bacterial CNS infection and concurrent comorbidities (CC). These observational or pragmatic trial designs compare accuracy, time-to-diagnosis, antibiotic exposure, and downstream resource utilization across diagnostic pathways in heterogeneous inpatient populations. Such research is relevant to providers and payers because more efficient, accurate diagnostic approaches can reduce unnecessary empiric therapies, lower lengths of stay, and decrease costs from misdirected treatments while preserving patient safety.
    • Post-discharge prospective cohort and outcomes research evaluating functional recovery, readmission risk, and long-term neurologic sequelae among survivors of non-bacterial CNS infections with complicating comorbidities, including studies of rehabilitation needs, cognitive outcomes, and health-related quality of life over 6–12 months. These studies follow patients after hospital discharge to quantify durable disability, service utilization (rehab, home health, readmissions), and predictors of poor outcomes, stratified by initial inpatient severity and complications. This information helps discharge planners, rehabilitation providers, and payers plan longitudinal care pathways and allocate resources for post-acute services to reduce readmissions and improve value 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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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.