ICD-10 Coding for Streptococcus Bacteremia(A40.0, A40.1, R78.81)
Complete ICD-10-CM coding and documentation guide for Streptococcus Bacteremia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Streptococcus Bacteremia
A40-A41Primary Range
Streptococcal and other bacterial sepsis
This range includes codes for sepsis due to streptococcal infections, which are relevant when bacteremia progresses to sepsis.
Bacteremia
This code is used for bacteremia without systemic inflammatory response syndrome (SIRS).
Streptococcus as the cause of diseases classified elsewhere
These codes identify the specific streptococcal 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 |
|---|---|---|---|
| A40.0 | Sepsis due to streptococcus group A | Use when bacteremia progresses to sepsis with group A streptococcus. |
|
| A40.1 | Sepsis due to streptococcus group B | Use when bacteremia progresses to sepsis with group B streptococcus. |
|
| R78.81 | Bacteremia | Use when bacteremia is present without systemic inflammatory response. |
|
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 streptococcus bacteremia
Essential facts and insights about Streptococcus Bacteremia
Primary ICD-10-CM Codes for streptococcus bacteremia
Decision Criteria
clinical Criteria
- Presence of systemic inflammatory response syndrome (SIRS) criteria
Applicable To
- Sepsis due to group A streptococcus
Excludes
- Bacteremia without sepsis
Clinical Validation Requirements
- Positive blood cultures for group A streptococcus
- Clinical signs of sepsis (e.g., fever, tachycardia)
Code-Specific Risks
- Confusing bacteremia with sepsis
Coding Notes
- Ensure documentation specifies sepsis due to group A streptococcus.
A40.1 - Sepsis due to streptococcus group B
Use when bacteremia progresses to sepsis with group B streptococcus.
Applicable To
- Sepsis due to group B streptococcus
Excludes
- Bacteremia without sepsis
Clinical Validation Requirements
- Positive blood cultures for group B streptococcus
- Clinical signs of sepsis (e.g., fever, tachycardia)
Coding Notes
Ensure documentation specifies sepsis due to group B streptococcus.
R78.81 - Bacteremia
Use when bacteremia is present without systemic inflammatory response.
Applicable To
- Presence of bacteria in the blood without systemic infection
Excludes
- Sepsis
Clinical Validation Requirements
- Positive blood cultures without clinical signs of sepsis
Coding Notes
Do not use as a principal diagnosis if sepsis is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Streptococcus Bacteremia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A40.0.
Impact
Clinical: Misrepresents the severity of the condition., Regulatory: May result in compliance issues during audits., Financial: Leads to incorrect DRG assignment and potential revenue loss.
Mitigation Strategy
Review clinical documentation for sepsis criteria., Ensure organism and systemic response are documented.
Impact
Reimbursement: Incorrect coding may lead to lower DRG assignment., Compliance: May result in audit discrepancies., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies systemic inflammatory response for sepsis coding.
Impact
Incorrect coding of bacteremia as sepsis or vice versa.
Mitigation Strategy
Ensure clear documentation of systemic response and organism.
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 Streptococcus Bacteremia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Streptococcus Bacteremia
Use these documentation templates to ensure complete and accurate documentation for Streptococcus Bacteremia. These templates include all required elements for proper coding and billing.
Sepsis due to streptococcus
Specialty: Infectious DiseaseRequired Elements
- Positive blood culture results
- Clinical signs of sepsis
- Organism identification
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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