ICD-10 Coding for Enterobacter cloacae Infection(A41.5, J15.29, N39.0)
Complete ICD-10-CM coding and documentation guide for Enterobacter cloacae Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Enterobacter cloacae Infection
A40-A41Primary Range
Sepsis due to other specified bacteria
Primary range for coding sepsis caused by Enterobacter cloacae.
Bacterial pneumonia, not elsewhere classified
Relevant for coding pneumonia due to Enterobacter cloacae.
Other diseases of urinary system
Relevant for coding urinary tract infections caused by Enterobacter cloacae.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A41.5 | Sepsis due to other Gram-negative organisms | Use when sepsis is confirmed to be caused by Enterobacter cloacae. |
|
| J15.29 | Pneumonia due to other Gram-negative bacteria | Use when pneumonia is confirmed to be caused by Enterobacter cloacae. |
|
| N39.0 | Urinary tract infection, site not specified | Use when a UTI is confirmed to be caused by Enterobacter cloacae. |
|
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 Enterobacter cloacae sepsis
Essential facts and insights about Enterobacter cloacae Infection
Primary ICD-10-CM Codes for enterobacter cloacae
Decision Criteria
clinical Criteria
- Presence of systemic inflammatory response syndrome (SIRS) criteria.
documentation Criteria
- Physician documentation of sepsis due to Enterobacter cloacae.
Applicable To
- Sepsis due to Enterobacter cloacae
Excludes
- Sepsis due to E. coli (A41.51)
Clinical Validation Requirements
- Positive blood cultures for Enterobacter cloacae
- Clinical signs of sepsis (e.g., fever, tachycardia)
Code-Specific Risks
- Misidentifying the organism leading to incorrect coding.
Coding Notes
- Ensure sepsis is documented by the physician, not inferred by the coder.
J15.29 - Pneumonia due to other Gram-negative bacteria
Use when pneumonia is confirmed to be caused by Enterobacter cloacae.
Applicable To
- Pneumonia due to Enterobacter cloacae
Excludes
- Pneumonia due to E. coli (J15.5)
Clinical Validation Requirements
- Sputum culture positive for Enterobacter cloacae
- Radiological evidence of pneumonia
Coding Notes
Ensure documentation specifies the organism and site of infection.
N39.0 - Urinary tract infection, site not specified
Use when a UTI is confirmed to be caused by Enterobacter cloacae.
Applicable To
- UTI due to Enterobacter cloacae
Excludes
- UTI due to E. coli (N39.0)
Clinical Validation Requirements
- Urine culture positive for Enterobacter cloacae
- Symptoms of urinary tract infection
Coding Notes
Ensure documentation specifies the organism and site of infection.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified bacterial agents as the cause of diseases classified elsewhere
B96.29Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Enterobacter cloacae Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A41.5.
Impact
Clinical: Leads to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure species is documented in clinical notes., Use lab results to confirm species.
Impact
Clinical: Inaccurate diagnosis and treatment., Regulatory: Fails to meet documentation standards., Financial: May result in claim denials.
Mitigation Strategy
Include method of detection in clinical notes., Ensure lab results are attached to patient records.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10-CM standards., Data Quality: Inaccurate data reporting and analysis.
Mitigation Strategy
Use standard ICD-10-CM codes such as A41.5 for sepsis.
Impact
Reimbursement: May affect DRG assignment and reimbursement., Compliance: Failure to comply with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always use B96.29 to specify Enterobacter cloacae as the causative organism.
Impact
Coding sepsis based on symptoms without explicit documentation.
Mitigation Strategy
Ensure physician documents sepsis explicitly in the medical record.
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 Enterobacter cloacae Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Enterobacter cloacae Infection
Use these documentation templates to ensure complete and accurate documentation for Enterobacter cloacae Infection. These templates include all required elements for proper coding and billing.
Ventilator-Associated Pneumonia
Specialty: PulmonologyRequired Elements
- Organism name
- Site of infection
- Method of identification
- Susceptibility testing
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Catheter-Associated UTI
Specialty: UrologyRequired Elements
- Organism name
- Site of infection
- Method of identification
- Susceptibility testing
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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