ICD-10 Coding for Enterococcus faecalis Infections(B95.2, A41.81, N39.0)
Complete ICD-10-CM coding and documentation guide for Enterococcus faecalis Infections. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Enterococcus faecalis Infections
B95-B97Primary Range
Bacterial and viral infectious agents
This range includes codes for infectious agents as the cause of diseases classified elsewhere, such as Enterococcus faecalis.
Other sepsis
This range includes codes for sepsis, including sepsis due to Enterococcus faecalis.
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 to specify the organism causing the infection. |
|
| A41.81 | Sepsis due to Enterococcus | Use when sepsis is confirmed or suspected to be due to Enterococcus faecalis. |
|
| N39.0 | Urinary tract infection, site not specified | Use as a primary code for UTIs 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 Infections
Primary ICD-10-CM Codes for physician initial faecalis
Decision Criteria
coding Criteria
- Use when Enterococcus faecalis is identified as the causative organism.
Applicable To
- Enterococcus faecalis
Excludes
- Sepsis due to Enterococcus (A41.81)
Clinical Validation Requirements
- Positive culture identifying Enterococcus faecalis
Code-Specific Risks
- Incorrect sequencing as primary code
Coding Notes
- Ensure correct sequencing with the primary infection code.
A41.81 - Sepsis due to Enterococcus
Use when sepsis is confirmed or suspected to be due to Enterococcus faecalis.
Applicable To
- Sepsis due to Enterococcus faecalis
Clinical Validation Requirements
- Blood cultures positive for Enterococcus faecalis
- Clinical signs of sepsis (e.g., fever, tachycardia)
Coding Notes
Ensure documentation supports sepsis criteria.
N39.0 - Urinary tract infection, site not specified
Use as a primary code for UTIs caused by Enterococcus faecalis.
Applicable To
- UTI due to Enterococcus faecalis
Clinical Validation Requirements
- Urine culture positive for Enterococcus faecalis
Coding Notes
Ensure urine culture results are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Severe sepsis with septic shock
R65.21Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Enterococcus faecalis Infections to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B95.2.
Impact
Clinical: Inadequate treatment targeting, Regulatory: Non-compliance with coding standards, Financial: Potential reimbursement issues
Mitigation Strategy
Ensure lab results are reviewed and documented, Use EHR prompts for organism documentation
Impact
Reimbursement: Potential loss of reimbursement due to non-specific coding, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Decreased data quality and accuracy
Mitigation Strategy
Query for 'sepsis due to E. faecalis UTI'
Impact
High risk of audit if sepsis is coded without specifying the organism.
Mitigation Strategy
Ensure all sepsis cases have documented organism identification.
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 Infections, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Enterococcus faecalis Infections
Use these documentation templates to ensure complete and accurate documentation for Enterococcus faecalis Infections. These templates include all required elements for proper coding and billing.
Sepsis due to Enterococcus faecalis
Specialty: Infectious DiseaseRequired Elements
- Patient demographics
- Clinical presentation
- Blood culture results
- Sepsis criteria
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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