ICD-10 Coding for E. coli Infection(A41.51, A04.0, B96.20)
Complete ICD-10-CM coding and documentation guide for E. coli Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to E. coli Infection
A41.5-A41.59Primary Range
Sepsis due to other Gram-negative organisms
Primary range for coding sepsis due to E. coli.
Enteropathogenic Escherichia coli infection
Used for gastrointestinal infections caused by E. coli.
Unspecified Escherichia coli as the cause of diseases classified elsewhere
Used as an ancillary code to specify E. coli as the causative organism.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A41.51 | Sepsis due to Escherichia coli | Use when sepsis is confirmed to be due to E. coli. |
|
| A04.0 | Enteropathogenic Escherichia coli infection | Use for gastrointestinal infections confirmed to be caused by enteropathogenic E. coli. |
|
| B96.20 | Unspecified Escherichia coli as the cause of diseases classified elsewhere | Use as a secondary code to specify E. coli as the causative organism in infections coded elsewhere. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for E. coli sepsis
Essential facts and insights about E. coli Infection
Primary ICD-10-CM Codes for ecoli
Decision Criteria
clinical Criteria
- Presence of clinical signs of sepsis with positive E. coli cultures.
documentation Criteria
- Provider documentation linking sepsis to E. coli.
Applicable To
- Sepsis due to E. coli
Excludes
- Bacteremia without sepsis
Clinical Validation Requirements
- Blood cultures positive for E. coli
- Clinical signs of sepsis (e.g., fever, tachycardia)
Code-Specific Risks
- Incorrectly coding as unspecified sepsis (A41.9) when organism is known.
Coding Notes
- Ensure documentation specifies E. coli as the cause of sepsis.
A04.0 - Enteropathogenic Escherichia coli infection
Use for gastrointestinal infections confirmed to be caused by enteropathogenic E. coli.
Applicable To
- Diarrhea due to enteropathogenic E. coli
Excludes
- Other types of bacterial gastroenteritis
Clinical Validation Requirements
- Stool culture or PCR confirming enteropathogenic E. coli
Coding Notes
Ensure stool culture or PCR results are documented.
B96.20 - Unspecified Escherichia coli as the cause of diseases classified elsewhere
Use as a secondary code to specify E. coli as the causative organism in infections coded elsewhere.
Applicable To
- E. coli as a secondary cause
Excludes
- Primary infections coded elsewhere
Clinical Validation Requirements
- Culture results indicating E. coli as the causative organism
Coding Notes
Ensure linkage between E. coli and the primary infection is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified Escherichia coli as the cause of diseases classified elsewhere
B96.20Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting E. coli Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A41.51.
Impact
Clinical: Leads to less specific clinical data., Regulatory: Non-compliance with coding specificity requirements., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Query provider for organism specificity., Review lab results for organism identification.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Always document and code the specific site of infection.
Impact
Risk of using unspecified codes when organism is documented.
Mitigation Strategy
Regular audits of sepsis documentation and coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for E. coli Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for E. coli Infection
Use these documentation templates to ensure complete and accurate documentation for E. coli Infection. These templates include all required elements for proper coding and billing.
E. coli UTI
Specialty: UrologyRequired Elements
- Urine culture results
- Symptoms of UTI
- Antibiotic treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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