ICD-10 Coding for Enterobacter Infection(B96.21, A41.5, Z22.35)
Complete ICD-10-CM coding and documentation guide for Enterobacter Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Enterobacter Infection
B95-B97Primary Range
Bacterial agents as the cause of diseases classified elsewhere
This range includes codes for bacterial infections, including Enterobacter as a causative agent.
Resistance to antimicrobial drugs
This range includes codes for documenting antibiotic resistance, relevant for Enterobacter infections.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B96.21 | Enterobacter as the cause of diseases classified elsewhere | Use when Enterobacter is confirmed as the causative agent of an infection. |
|
| A41.5 | Sepsis due to other Gram-negative organisms | Use when sepsis is confirmed to be caused by Enterobacter. |
|
| Z22.35 | Carrier of Enterobacterales | Use for asymptomatic carriers of Enterobacter. |
|
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 infection
Essential facts and insights about Enterobacter Infection
Primary ICD-10-CM Codes for enterobacter
Decision Criteria
clinical Criteria
- Enterobacter species identified in culture
documentation Criteria
- Link between Enterobacter and infection symptoms
Applicable To
- Enterobacter cloacae
- Enterobacter aerogenes
Excludes
- Carrier state without active infection (Z22.35)
Clinical Validation Requirements
- Positive culture identifying Enterobacter species
- Clinical correlation with infection symptoms
Code-Specific Risks
- Misidentifying the organism without culture confirmation
Coding Notes
- Ensure organism identification is documented in the medical record.
A41.5 - Sepsis due to other Gram-negative organisms
Use when sepsis is confirmed to be caused by Enterobacter.
Applicable To
- Sepsis due to Enterobacter
Excludes
- Sepsis due to specified Gram-negative organisms (A41.4)
Clinical Validation Requirements
- Blood culture positive for Enterobacter
- Clinical signs of sepsis
Coding Notes
Ensure sepsis criteria are met and documented.
Z22.35 - Carrier of Enterobacterales
Use for asymptomatic carriers of Enterobacter.
Applicable To
- Asymptomatic carrier state
Excludes
- Active infection (B96.21)
Clinical Validation Requirements
- Positive culture without symptoms
Coding Notes
Ensure no symptoms are present for carrier coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B96.21.
Impact
Clinical: Leads to vague clinical data, Regulatory: May trigger audits, Financial: Potential reimbursement issues
Mitigation Strategy
Always specify organism, Use culture results for coding
Impact
Reimbursement: Incorrect reimbursement for active treatment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use B96.21 when symptoms are present.
Impact
Reimbursement: Potential underpayment for complex cases, Compliance: Failure to meet reporting requirements, Data Quality: Incomplete resistance data
Mitigation Strategy
Add Z16.23 when carbapenem resistance is confirmed.
Impact
Failure to document and code resistance accurately.
Mitigation Strategy
Implement checks for resistance documentation in coding workflows.
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 Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Enterobacter Infection
Use these documentation templates to ensure complete and accurate documentation for Enterobacter Infection. These templates include all required elements for proper coding and billing.
Hospital-acquired pneumonia due to Enterobacter
Specialty: Infectious DiseaseRequired Elements
- Culture results
- Antibiotic resistance
- Sepsis criteria
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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