ICD-10 Coding for Streptococcal Bacteremia(A40.1, A49.1)
Complete ICD-10-CM coding and documentation guide for Streptococcal Bacteremia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Streptococcal Bacteremia
A40-A41Primary Range
Streptococcal and other septicemia
This range includes codes for streptococcal sepsis and septicemia, which are primary for streptococcal bacteremia when sepsis criteria are met.
Bacterial infections of unspecified site
Used for unspecified streptococcal infections when sepsis is not present.
Streptococcus and Enterococcus as the cause of diseases classified elsewhere
Used as an additional code to identify the organism causing the infection.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A40.1 | Sepsis due to Streptococcus, group B | Use when sepsis is confirmed with Group B Streptococcus as the causative organism. |
|
| A49.1 | Streptococcal infection, unspecified site | Use when bacteremia is confirmed without sepsis. |
|
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 streptococcal bacteremia
Essential facts and insights about Streptococcal Bacteremia
Primary ICD-10-CM Codes for streptococcal bacteremia
Decision Criteria
clinical Criteria
- Presence of SIRS criteria and positive blood culture for Group B Streptococcus.
Applicable To
- Group B streptococcal sepsis
Excludes
- Streptococcal toxic shock syndrome (A48.3)
Clinical Validation Requirements
- Blood cultures positive for Streptococcus agalactiae
- Presence of SIRS criteria
Code-Specific Risks
- Misidentification of the organism can lead to incorrect coding.
Coding Notes
- Ensure documentation specifies Group B Streptococcus and meets sepsis criteria.
A49.1 - Streptococcal infection, unspecified site
Use when bacteremia is confirmed without sepsis.
Applicable To
- Streptococcal bacteremia without sepsis
Excludes
- Sepsis due to streptococcus (A40.-)
Clinical Validation Requirements
- Positive blood cultures for Streptococcus species
- No systemic inflammatory response syndrome (SIRS) criteria
Coding Notes
Ensure documentation specifies the species of Streptococcus.
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 Streptococcal Bacteremia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A40.1.
Impact
Clinical: May lead to inappropriate treatment choices., Regulatory: Non-compliance with coding guidelines., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Ensure lab results are reviewed and documented., Use queries to clarify unspecified documentation.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement rates., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Impacts the accuracy of clinical data.
Mitigation Strategy
Use A40.X codes for sepsis when criteria are met.
Impact
Incorrect coding of sepsis when criteria are not fully documented.
Mitigation Strategy
Ensure complete documentation of SIRS criteria and 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 Streptococcal Bacteremia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Streptococcal Bacteremia
Use these documentation templates to ensure complete and accurate documentation for Streptococcal Bacteremia. These templates include all required elements for proper coding and billing.
Streptococcal bacteremia without sepsis
Specialty: Infectious DiseaseRequired Elements
- Positive blood culture result
- No SIRS criteria
- Antibiotic treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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