ICD-10 Coding for MRSA Infection(A41.02, J15.212, Z22.322)
Complete ICD-10-CM coding and documentation guide for MRSA Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to MRSA Infection
A41-A41.9Primary Range
Sepsis due to MRSA
This range includes codes for sepsis caused by MRSA, which is a common and serious manifestation of MRSA infection.
Pneumonia due to MRSA
This range includes codes for pneumonia caused by MRSA, another frequent presentation of MRSA infection.
Carrier of infectious disease
This range includes codes for individuals who are carriers of MRSA without active infection.
Personal history of MRSA
This range is used for documenting a resolved history of MRSA 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 |
|---|---|---|---|
| A41.02 | Sepsis due to Methicillin-resistant Staphylococcus aureus | Use when sepsis is confirmed to be caused by MRSA. |
|
| J15.212 | Pneumonia due to Methicillin-resistant Staphylococcus aureus | Use when pneumonia is confirmed to be caused by MRSA. |
|
| Z22.322 | Carrier of Methicillin-resistant Staphylococcus aureus | Use for patients identified as carriers 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 infection
Essential facts and insights about MRSA Infection
Primary ICD-10-CM Codes for mrsa infection
Decision Criteria
clinical Criteria
- Presence of MRSA confirmed by culture
documentation Criteria
- Sepsis symptoms documented
Applicable To
- Sepsis due to MRSA
Excludes
- Sepsis due to other organisms
Clinical Validation Requirements
- Confirmed MRSA via blood culture
- Clinical signs of sepsis (e.g., fever, tachycardia)
Code-Specific Risks
- High audit risk if sepsis is not corroborated by clinical evidence.
Coding Notes
- Ensure documentation specifies MRSA as the causative organism.
J15.212 - Pneumonia due to Methicillin-resistant Staphylococcus aureus
Use when pneumonia is confirmed to be caused by MRSA.
Applicable To
- MRSA pneumonia
Excludes
- Pneumonia due to other organisms
Clinical Validation Requirements
- Confirmed MRSA via sputum culture
- Radiological evidence of pneumonia
Coding Notes
Document MRSA confirmation and pneumonia diagnosis clearly.
Z22.322 - Carrier of Methicillin-resistant Staphylococcus aureus
Use for patients identified as carriers of MRSA without active infection.
Applicable To
- MRSA carrier state
Excludes
- Active MRSA infection
Clinical Validation Requirements
- Positive MRSA screen without symptoms 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 MRSA Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A41.02.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Always confirm MRSA with lab results before coding., Ensure documentation includes culture findings.
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient conditions.
Mitigation Strategy
Always use a condition-specific code first, followed by B95.62 if needed.
Impact
Using B95.62 as a primary code instead of a secondary code.
Mitigation Strategy
Educate coding staff on proper sequencing rules and conduct regular audits.
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 Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for MRSA Infection
Use these documentation templates to ensure complete and accurate documentation for MRSA Infection. These templates include all required elements for proper coding and billing.
MRSA Pneumonia
Specialty: PulmonologyRequired Elements
- Chief complaint
- Past medical history
- Lab results
- Imaging findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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