ICD-10 Guide

A05.5

Campylobacter enteritis

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/04/2025

Code Description

ICD-10 A05.5 is a billable code used to indicate a diagnosis of campylobacter enteritis.

Key Diagnostic Point:

A05.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

### ICD-10 Code Analysis: A05.5 - Campylobacter Enteritis #### Complexity Rating: Medium #### Factors Contributing to Complexity: 1. **Clinical Presentation:** - Campylobacter enteritis can present with a variety of symptoms, including diarrhea (which may be bloody), abdominal pain, fever, and nausea. This variability can complicate diagnosis and coding. 2. **Differential Diagnosis:** - The symptoms of Campylobacter enteritis can overlap with other gastrointestinal infections (e.g., Salmonella, Shigella, and E. coli infections), requiring careful clinical evaluation to confirm the specific etiology. 3. **Laboratory Diagnostics:** - Confirmation of Campylobacter infection typically requires specific laboratory tests (e.g., stool culture), which may not always be performed or documented, impacting the coding accuracy. 4. **Complications:** - Potential complications, such as reactive arthritis or Guillain-Barré syndrome, may arise from Campylobacter infections. Documentation and coding of these complications must be considered to ensure accurate representation of the patient's condition. 5. **Epidemiological Context:** - The determination of whether the infection is community-acquired or healthcare-associated can affect coding and management strategies; this context must be documented accurately. #### Audit Risks and Considerations: 1. **Coding Accuracy:** - Inaccurate coding can occur if the clinical documentation does not clearly support the diagnosis of Campylobacter enteritis. Auditors may challenge the appropriateness of the A05.5 code if documentation lacks specificity. 2. **Incomplete Documentation:** - Failure to document the results of laboratory tests or the clinical rationale for the diagnosis may lead to denial of claims or incorrect coding. 3. **Complications and Comorbidities:** - If complications arising from Campylobacter enteritis are not documented, it may result in an underestimation of the complexity of the patient's condition, impacting resource allocation and reimbursement. 4. **Clinical Validation:** - Auditors may require clinical validation of the diagnosis based on symptoms, laboratory findings, and treatment plans, making it essential to ensure comprehensive documentation. #### Documentation Requirements: 1. **Symptomatology:** - Detailed documentation of presenting symptoms (e.g., diarrhea characteristics, abdominal pain) is necessary to support the diagnosis. 2. **Laboratory Results:** - Clear documentation of laboratory tests performed, including stool cultures and any identification of Campylobacter species, should be included in the medical record. 3. **Clinical Assessment:** - A thorough clinical assessment must be documented, including any differential diagnoses considered and the rationale for confirming Campylobacter enteritis. 4. **Treatment Plan:** - Documentation of the treatment plan, including prescribed medications (e.g., antibiotics if indicated) and follow-up recommendations, is essential. 5. **Complications:** - If complications develop, these must be documented separately with appropriate codes to reflect the patient's overall clinical picture accurately. By ensuring all these aspects are addressed in the documentation, healthcare providers can enhance the accuracy of coding for A05.5 - Campylobacter enteritis, potentially reducing audit risks and improving patient care management.

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Standard requirements apply

Common Clinical Scenarios

Various clinical presentations

Billing Considerations

Follow standard billing guidelines

Coding Guidelines

Inclusion Criteria

Use A05.5 When

Comprehensive Coding Guidelines for ICD
10 Code A05
Campylobacter Enteritis
When to Use A05
5 vs Related Codes
Campylobacter Enteritis is specifically used for cases of enteritis caused by Campylobacter species
This code should be used when:
A patient presents with diarrhea, abdominal pain, fever, or other gastrointestinal symptoms specifically linked to a Campylobacter infection

Exclusion Criteria

Do NOT use A05.5 When

Inclusion and Exclusion Criteria
Exclusion Criteria:
Accurate documentation, understanding of related codes, and adherence to inclusion and exclusion criteria are paramount in preventing common coding errors

Related CPT Codes

No CPT Codes Available

Related CPT codes for this diagnosis will be displayed here when available.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Changes from ICD-9 to ICD-10

- In ICD-9, Campylobacter enteritis was coded as 003.0, which was a relatively broad category that covered various causes of enteritis.

ICD-9 vs ICD-10

The implementation of ICD-10 brought significant changes to the coding landscape, particularly for conditions such as Campylobacter enteritis, represented by the ICD-10 code A05.5. Below is a comprehensive overview of the impact of ICD-10 implementation on this specific code and its associated clinical implications: Changes from ICD-9 to ICD-10 1. Code Structure: - In ICD-9, Campylobacter enteritis was coded as 003.0, which was a relatively broad category that covered various causes of enteritis. - ICD-10 introduced more specificity with the code A05.5, which distinctly classifies Campylobacter enteritis as a unique entity under the broader category of bacterial intestinal infections. 2. Expanded Categories: - ICD-10 offers a more granular classification of infectious diseases, which allows for better tracking and management of infectious disease outbreaks, enhancing epidemiological data collection. Specificity Improvements - Detailed Classification: - A05.5 allows for detailed documentation of the condition, including the specific causative agent (Campylobacter), which aids in...

A05.5

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions

A05.5

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions