ICD-10 Coding for Staphylococcus aureus(A41.02, J15.212)
Complete ICD-10-CM coding and documentation guide for Staphylococcus aureus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Staphylococcus aureus
A41.0-A41.9Primary Range
Sepsis due to various organisms
Includes sepsis due to Staphylococcus aureus, both MRSA and MSSA.
Staphylococcus as the cause of diseases classified elsewhere
Used as an additional code to identify the infectious agent in diseases classified elsewhere.
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 due to MRSA. |
|
| J15.212 | Pneumonia due to Methicillin-resistant Staphylococcus aureus | Use when pneumonia is confirmed to be due to MRSA. |
|
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 sepsis
Essential facts and insights about Staphylococcus aureus
Primary ICD-10-CM Codes for staphylococcus aureus
Decision Criteria
clinical Criteria
- MRSA confirmed by culture or PCR
documentation Criteria
- Sepsis symptoms documented
Applicable To
- Sepsis due to MRSA
Excludes
- Sepsis due to MSSA (A41.01)
Clinical Validation Requirements
- Positive blood culture for MRSA
- Clinical signs of sepsis
Code-Specific Risks
- Incorrectly using for MSSA
- Missing documentation of MRSA
Coding Notes
- Ensure MRSA is documented as the causative organism.
J15.212 - Pneumonia due to Methicillin-resistant Staphylococcus aureus
Use when pneumonia is confirmed to be due to MRSA.
Applicable To
- MRSA pneumonia
Excludes
- Pneumonia due to MSSA (J15.211)
Clinical Validation Requirements
- Positive sputum culture for MRSA
- Radiological evidence of pneumonia
Coding Notes
Ensure MRSA is documented as the causative organism.
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 Staphylococcus aureus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A41.02.
Impact
Clinical: Inaccurate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Specify organism and site, Use precise medical terminology
Impact
Reimbursement: Incorrect reimbursement due to improper primary code usage., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data reporting and analysis.
Mitigation Strategy
Use B95.62 only as a secondary code when no combination code exists.
Impact
Using B95.62 as a primary code instead of a secondary code.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Staphylococcus aureus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Staphylococcus aureus
Use these documentation templates to ensure complete and accurate documentation for Staphylococcus aureus. These templates include all required elements for proper coding and billing.
MRSA Pneumonia
Specialty: PulmonologyRequired Elements
- Organism identification
- Anatomic site
- Test type
- Treatment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Staphylococcus aureus? Ask your questions below.