ICD-10 Coding for Methicillin-Resistant Staphylococcus Aureus(J15.212, A41.02, L02.416, Z22.322)
Complete ICD-10-CM coding and documentation guide for Methicillin-Resistant Staphylococcus Aureus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Methicillin-Resistant Staphylococcus Aureus
Infections of the skin and subcutaneous tissue
Includes codes for skin infections caused by MRSA.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J15.212 | Pneumonia due to Methicillin-resistant Staphylococcus aureus | Use when pneumonia is confirmed to be caused by MRSA. |
|
| A41.02 | Sepsis due to Methicillin-resistant Staphylococcus aureus | Use when sepsis is confirmed to be caused by MRSA. |
|
| L02.416 | Cutaneous abscess of the trunk | Use for skin abscesses confirmed to be caused by MRSA. |
|
| Z22.322 | Carrier of Methicillin-resistant Staphylococcus aureus | Use when a patient is a known carrier of MRSA without active infection. |
|
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 MRSA pneumonia
Essential facts and insights about Methicillin-Resistant Staphylococcus Aureus
Primary ICD-10-CM Codes for methicillin resistant staphylococcus aureus
Decision Criteria
clinical Criteria
- Confirmed MRSA in sputum culture
Applicable To
- MRSA pneumonia
Excludes
- Pneumonia due to other specified bacteria
Clinical Validation Requirements
- Chest X-ray showing consolidation
- Sputum culture positive for MRSA
Code-Specific Risks
- Incorrect use without lab confirmation
Coding Notes
- Ensure documentation specifies MRSA as the causative agent.
A41.02 - Sepsis due to Methicillin-resistant Staphylococcus aureus
Use when sepsis is confirmed to be caused by MRSA.
Applicable To
- MRSA sepsis
Excludes
- Sepsis due to other specified bacteria
Clinical Validation Requirements
- Blood culture positive for MRSA
- Clinical signs of sepsis
Coding Notes
Ensure documentation specifies MRSA as the causative agent.
L02.416 - Cutaneous abscess of the trunk
Use for skin abscesses confirmed to be caused by MRSA.
Applicable To
- Skin abscess
Excludes
- Abscess of internal organs
Clinical Validation Requirements
- Clinical diagnosis of abscess
- MRSA confirmed by culture
Coding Notes
Ensure documentation specifies MRSA as the causative agent.
Z22.322 - Carrier of Methicillin-resistant Staphylococcus aureus
Use when a patient is a known carrier of MRSA without active infection.
Applicable To
- MRSA carrier
Excludes
- Active MRSA infection
Clinical Validation Requirements
- Positive MRSA screening test
- No clinical signs of infection
Coding Notes
Ensure documentation specifies carrier status without active infection.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Methicillin-resistant Staphylococcus aureus as the cause of diseases classified elsewhere
B95.62Differential 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 Methicillin-Resistant Staphylococcus Aureus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J15.212.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Educate clinicians on documentation standards, Use templates that prompt for specific organism
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use site-specific codes with B95.62 for MRSA causality.
Impact
Using non-specific codes for MRSA infections.
Mitigation Strategy
Use site-specific codes with B95.62 when applicable.
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 Methicillin-Resistant Staphylococcus Aureus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Methicillin-Resistant Staphylococcus Aureus
Use these documentation templates to ensure complete and accurate documentation for Methicillin-Resistant Staphylococcus Aureus. These templates include all required elements for proper coding and billing.
Skin Infection
Specialty: Emergency MedicineRequired Elements
- Infection site
- MRSA confirmation
- Treatment details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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