Infection ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Infection

Medical billing and coding rely on a systematic classification system known as the International Classification of Diseases, 10th Edition (ICD-10). Let us delve into the frequently used Infection ICD-10 Codes. 

Each code carries a clinical description that provides valuable information about the nature of the infection. These codes are pivotal in the healthcare ecosystem, facilitating accurate documentation, insurance claim processing, and efficient patient care: 

• A09 - Infectious Gastroenteritis and Colitis, Unspecified: A09 is the code designated for infectious gastroenteritis and colitis where the specific cause is unspecified. This code helps healthcare professionals classify these gastrointestinal infections for record-keeping and further analysis.
• B95 - Streptococcus, Staphylococcus, and Enterococcus as the Cause of Diseases Classified Elsewhere: B95 is employed when infections are attributable to specific bacteria, such as Streptococcus, Staphylococcus, and Enterococcus, and have led to diseases classified elsewhere.
• J02 - Acute Pharyngitis: J02 stands for acute pharyngitis, a condition characterized by acute inflammation and infection of the pharynx, often resulting in a sore throat. This code helps accurately document cases of throat infections.
• K74 - Fibrosis and Cirrhosis of Liver: Infections that cause fibrosis and cirrhosis of the liver are categorized under K74. This code is indispensable in the management of liver-related conditions.
• N39.0 - Urinary Tract Infection, Site Not Specified: When the location of a urinary tract infection is unspecified, N39.0 is used for precise recording and analysis of such cases.
• O23.3 - Infections of Kidney in Pregnancy: O23.3 is utilized when kidney infections occur during pregnancy. Accurate classification of these cases is vital for ensuring safe maternal and fetal health.
• P36.9 - Bacterial Sepsis of Newborn, Unspecified: P36.9 is the code applied when newborns are affected by bacterial sepsis, whose specific cause remains unidentified. It aids in documenting these critical neonatal infections.
• R50.9 - Fever, Unspecified: When infection leads to an unspecified fever, R50.9 is employed for uniform documentation, allowing healthcare providers to recognize fever-related symptoms.
• Z20.9 - Contact with and Exposure to Unspecified Communicable Disease: Z20.9 is assigned when an individual has been exposed to a communicable disease without a specific identification. It is a valuable code for tracking potential disease transmissions.
• B00.9 - Herpesviral Infection, Unspecified: In cases of unspecified herpesviral infections, B00.9 is the go-to code for accurate categorization and record-keeping.

Which Infection ICD Codes are Billable

• A09 - Infectious Gastroenteritis and Colitis, Unspecified: Yes.
• B95 - Streptococcus, Staphylococcus, and Enterococcus as the Cause of Diseases Classified Elsewhere: No, this code is not billable as it refers to the causative agents rather than the diseases themselves.
• J02 - Acute Pharyngitis: Yes.
• K74 - Fibrosis and Cirrhosis of Liver: No, this code is typically not billable as it relates to the consequences of infections rather than the infections themselves.
• N39.0 - Urinary Tract Infection, Site Not Specified: Yes.
• O23.3 - Infections of Kidney in Pregnancy: Yes.
• P36.9 - Bacterial Sepsis of Newborn, Unspecified: Yes.
• R50.9 - Fever, Unspecified: No, this code is not billable as it does not specify the underlying infection causing the fever.
• Z20.9 - Contact with and Exposure to Unspecified Communicable Disease: No, this code is not typically billable as it denotes exposure rather than a confirmed infection.
• B00.9 - Herpesviral Infection, Unspecified: Yes.

It's important to note that whether a specific ICD-10 code is billable or not depends on various factors, including the documentation of the patient's condition, the insurance policies, and the particular services rendered. 

Medical coders and billing specialists should ensure accurate and compliant coding practices based on healthcare organizations and insurers' specific context and guidelines. Always refer to the official coding and billing guidelines for the most up-to-date and accurate information.

Clinical Information

• Infections are a common category of health conditions, encompassing various diseases caused by microorganisms such as bacteria, viruses, fungi, and parasites.
• ICD (International Classification of Diseases) codes are alphanumeric identifiers that categorize and document various health conditions, including infections.
• These codes offer a systematic and standardized way to classify infections, aiding in managing patient records, insurance claims, and healthcare statistics.
• ICD-10 is the 10th edition of this coding system, and it includes specific codes for different types of infections and related conditions.
• Common infection-related ICD-10 codes cover conditions like urinary tract infections (N39.0), acute pharyngitis (J02), and infectious gastroenteritis (A09).
• ICD codes provide valuable clinical information, indicating the nature, location, and severity of infections, assisting healthcare professionals in diagnosis and treatment decisions.
• They play a crucial role in epidemiology, helping to track the prevalence of infectious diseases, identify outbreaks, and formulate public health strategies.
• Accurate use of infection-related ICD codes is essential for healthcare providers to receive proper reimbursement for their services and insurance claims processing.
• Proper documentation of clinical information, including ICD codes, is critical for patient care and ensuring that healthcare systems operate efficiently and effectively.
• ICD-10 codes for infections are a vital tool in the healthcare industry, promoting standardized record-keeping, accurate diagnosis, and appropriate treatments for infectious diseases.

Synonyms Include

• Contagion
• Ailment
• Malady
• Pathogen
• Microbial Invasion