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v1.0.0
ICD-10 Guide
DiagnosesHistory Of C Diff

History Of C Diff

ICD-10 Coding for History of C. diff(Z86.19)

PRIMARY SPECIALTYFamily Medicine
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is History Of C Diff?
Essential facts and insights about History of C. diff

Key Clinical Considerations:

  • Diarrhea (often watery) for three or more days
  • Abdominal pain or tenderness
  • Fever
  • Nausea
  • Key diagnostic tests include stool tests for C. difficile toxins and PCR assays
  • Physical exam may reveal abdominal distension or tenderness

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of C. difficile infection (CDI)
  • Current symptoms and duration
  • Previous treatments and outcomes
  • Specific coding terminology includes 'C. difficile colitis' or 'C. difficile infection'
  • Documentation examples: 'Patient has a history of recurrent C. difficile infection, currently presenting with diarrhea.'

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use A04.7 for confirmed CDI; consider A49.9 for unspecified infections.
  • Common errors: Misclassifying CDI as a viral infection or failing to document the history of CDI.

Code Exclusions

Important Exclusions

  • Excluded conditions: Non-infectious diarrhea or other gastrointestinal disorders.
  • Alternative codes: Consider using codes for complications or recurrent infections if applicable.

Related ICD-10 Codes

Primary Codes
A04.7
Other specified bacterial intestinal infections
A49.9
Bacterial infection, unspecified
Ancillary Codes
K52.9
R19.7
Differential Codes
A04.71
A04.71
for active recurrent infections, not for history.
A04.72
A04.72
for active non-recurrent infections, not for history.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Family Medicine

Specialty Applications

  • Patient populations: Individuals with a history of antibiotic use, elderly patients, and those with weakened immune systems.
  • Clinical settings: Family medicine practices, outpatient clinics, and hospitals.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document the patient's history, current symptoms, and any previous CDI episodes.

Billing considerations?

Ensure accurate coding to reflect the severity and history of the condition for appropriate reimbursement.