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ICD-10 Guide
ICD-10 CodesA36.9

A36.9

Meningococcal meningitis, unspecified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A36.9 is a billable code used to indicate a diagnosis of meningococcal meningitis, unspecified.

Key Diagnostic Point:

Meningococcal meningitis is a serious bacterial infection of the protective membranes covering the brain and spinal cord, caused by the Neisseria meningitidis bacterium. This condition can lead to severe complications, including brain damage, hearing loss, and learning disabilities. The unspecified designation indicates that the specific strain or serogroup of Neisseria meningitidis has not been identified, which can complicate treatment and management. Symptoms typically include sudden onset of fever, headache, stiff neck, nausea, vomiting, increased sensitivity to light, and altered mental status. Diagnosis is confirmed through lumbar puncture and analysis of cerebrospinal fluid (CSF). Treatment usually involves intravenous antibiotics, such as penicillin or ceftriaxone, and may require adjunctive therapies like corticosteroids to reduce inflammation. Early recognition and treatment are critical to improving outcomes and reducing the risk of long-term sequelae.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the code may lead to ambiguity in documentation.
  • Differentiation from other types of meningitis (viral, tuberculous) is necessary.
  • Requires thorough understanding of clinical presentation and diagnostic criteria.
  • Potential for misclassification if serogroup is not documented.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the type of meningitis.
  • Lack of supporting lab results in the medical record.
  • Inconsistent coding practices among providers.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on symptoms, lab results, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of meningitis cases, including outbreak investigations.

Billing Considerations

Need for clear documentation of serogroup identification when available.

Neurology

Documentation Requirements

Comprehensive neurological assessments and follow-up evaluations.

Common Clinical Scenarios

Management of neurological sequelae following meningitis.

Billing Considerations

Documentation of neurological deficits and recovery progress is crucial.

Coding Guidelines

Inclusion Criteria

Use A36.9 When
  • According to ICD
  • 10 coding guidelines, A36
  • 9 should be used when the specific type of meningococcal meningitis is not documented
  • Coders must ensure that the diagnosis is supported by clinical findings and laboratory results

Exclusion Criteria

Do NOT use A36.9 When
  • Exclusion criteria include other types of meningitis that should be coded separately

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to obtain CSF for analysis in suspected meningitis cases.

Documentation Requirements

Document indication for lumbar puncture and results of CSF analysis.

Specialty Considerations

Infectious disease specialists should ensure that CSF cultures are sent for appropriate testing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of meningococcal meningitis, improving the ability to track and manage outbreaks. However, the unspecified code A36.9 may lead to challenges in understanding the epidemiology of the disease.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of meningococcal meningitis, improving the ability to track and manage outbreaks. However, the unspecified code A36.9 may lead to challenges in understanding the epidemiology of the disease.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of meningococcal meningitis, improving the ability to track and manage outbreaks. However, the unspecified code A36.9 may lead to challenges in understanding the epidemiology of the disease.

Resources

Clinical References

  • •
    CDC Meningococcal Disease Information

Coding & Billing References

  • •
    CDC Meningococcal Disease Information

Frequently Asked Questions

When should A36.9 be used?

A36.9 should be used when a patient is diagnosed with meningococcal meningitis, but the specific serogroup has not been identified. It is important to ensure that the diagnosis is supported by clinical findings and laboratory results.