ICD-10 Coding for Enterococcus faecalis(B95.2, A41.81)
Complete ICD-10-CM coding and documentation guide for Enterococcus faecalis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Enterococcus faecalis
B95-B97Primary Range
Bacterial and viral infectious agents
This range includes codes for bacterial agents as the cause of diseases classified elsewhere, including Enterococcus.
Other diseases of the urinary system
This range includes codes for urinary tract infections, which can be caused by Enterococcus faecalis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B95.2 | Enterococcus as the cause of diseases classified elsewhere | Use as a secondary code when Enterococcus faecalis is identified as the causative organism of an infection. |
|
| A41.81 | Sepsis due to Enterococcus | Use when sepsis is confirmed to be caused by Enterococcus faecalis. |
|
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 Enterococcus faecalis
Essential facts and insights about Enterococcus faecalis
Primary ICD-10-CM Codes for enterococcus faecalis
Decision Criteria
clinical Criteria
- Positive identification of Enterococcus faecalis in culture
coding Criteria
- Use as a secondary code with a primary infection code
Applicable To
- Enterococcus faecalis as a secondary cause
Excludes
- Principal diagnosis without a primary infection code
Clinical Validation Requirements
- Positive culture identifying Enterococcus faecalis
- Documentation of infection site
Code-Specific Risks
- Incorrectly using as a primary diagnosis
Coding Notes
- Ensure the primary infection code is sequenced before B95.2.
A41.81 - Sepsis due to Enterococcus
Use when sepsis is confirmed to be caused by Enterococcus faecalis.
Applicable To
- Sepsis caused by Enterococcus faecalis
Excludes
- Sepsis due to other organisms
Clinical Validation Requirements
- Positive blood culture for Enterococcus faecalis
- Clinical signs of sepsis
Coding Notes
Ensure documentation supports sepsis diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Urinary tract infection, site not specified
N39.0Differential 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 Enterococcus faecalis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B95.2.
Impact
Clinical: Inaccurate treatment decisions, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always include culture results in documentation, Verify organism identification before coding
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always pair B95.2 with a primary infection code.
Impact
Failure to sequence primary and secondary codes correctly.
Mitigation Strategy
Regular training on ICD-10 sequencing rules.
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 Enterococcus faecalis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Enterococcus faecalis
Use these documentation templates to ensure complete and accurate documentation for Enterococcus faecalis. These templates include all required elements for proper coding and billing.
Enterococcus faecalis UTI
Specialty: UrologyRequired Elements
- Patient symptoms
- Culture results
- Antibiotic susceptibilities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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