ICD-10 Coding for MRSA Bacteremia(A41.02, R78.81, A49.02)
Complete ICD-10-CM coding and documentation guide for MRSA Bacteremia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to MRSA Bacteremia
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A41.02 | Sepsis due to Methicillin resistant Staphylococcus aureus | Use when MRSA bacteremia has progressed to sepsis. |
|
| R78.81 | Bacteremia | Use when MRSA is present in the blood without sepsis. |
|
| A49.02 | Methicillin resistant Staphylococcus aureus infection, unspecified site | Use when MRSA infection is confirmed but the site is unspecified. |
|
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 bacteremia
Essential facts and insights about MRSA Bacteremia
Primary ICD-10-CM Codes for mrsa bacteremia
Decision Criteria
clinical Criteria
- Presence of SIRS criteria with positive MRSA blood cultures
Applicable To
- Sepsis due to MRSA
Excludes
- Sepsis due to other organisms
Clinical Validation Requirements
- Positive blood cultures for MRSA
- Systemic inflammatory response syndrome (SIRS) criteria
Code-Specific Risks
- Incorrectly coding when sepsis criteria are not met
Coding Notes
- Ensure sepsis criteria are documented.
R78.81 - Bacteremia
Use when MRSA is present in the blood without sepsis.
Applicable To
- Presence of bacteria in the blood
Excludes
- Sepsis (A41.-)
Clinical Validation Requirements
- Positive blood cultures for bacteria
Coding Notes
Cannot be used as a principal diagnosis.
A49.02 - Methicillin resistant Staphylococcus aureus infection, unspecified site
Use when MRSA infection is confirmed but the site is unspecified.
Applicable To
- MRSA infection without specified site
Excludes
- Specific site infections (e.g., pneumonia, sepsis)
Clinical Validation Requirements
- Positive MRSA culture without specified site
Coding Notes
Use when the site of MRSA infection is not specified.
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 MRSA Bacteremia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A41.02.
Impact
Clinical: Potential misdiagnosis or under-treatment., Regulatory: Non-compliance with documentation standards., Financial: Incorrect coding leading to reimbursement issues.
Mitigation Strategy
Always specify the organism in documentation.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use A49.02 as the principal diagnosis with R78.81 as secondary.
Impact
Using R78.81 as a principal diagnosis instead of A49.02 or A41.02.
Mitigation Strategy
Ensure correct sequencing and use of codes based on clinical documentation.
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 MRSA Bacteremia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for MRSA Bacteremia
Use these documentation templates to ensure complete and accurate documentation for MRSA Bacteremia. These templates include all required elements for proper coding and billing.
MRSA Bacteremia with Sepsis
Specialty: Infectious DiseaseRequired Elements
- Positive blood cultures for MRSA
- Sepsis criteria documentation
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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