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ICD-10 Guide
ICD-10 CodesA40.8

A40.8

Other specified streptococcal sepsis

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

Code Description

ICD-10 A40.8 is a billable code used to indicate a diagnosis of other specified streptococcal sepsis.

Key Diagnostic Point:

Streptococcal sepsis is a severe systemic infection caused by various species of Streptococcus bacteria, which can lead to significant morbidity and mortality. This condition is characterized by the presence of bacteria in the bloodstream, resulting in a systemic inflammatory response that can progress to septic shock. Patients may present with fever, chills, tachycardia, hypotension, and altered mental status. The severity of the infection often necessitates intensive care unit (ICU) admission for close monitoring and aggressive management, including fluid resuscitation, vasopressor support, and broad-spectrum antibiotics. The specific type of streptococcal infection may vary, including Group A Streptococcus (GAS) or Group B Streptococcus (GBS), and the clinical presentation can range from mild to life-threatening. Early recognition and treatment are crucial to improving outcomes, and antimicrobial stewardship is essential to prevent resistance and ensure the effective use of antibiotics. This code is used when the sepsis is due to a specified type of streptococcus that does not fall under more common categories, necessitating careful documentation of the causative organism and clinical context.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of streptococcal species involved
  • Need for precise documentation of the causative organism
  • Differentiation from other types of sepsis
  • Potential for overlapping symptoms with other infections

Audit Risk Factors

  • Inadequate documentation of the specific streptococcal species
  • Failure to document the severity of the sepsis
  • Lack of clarity in the clinical presentation
  • Improper linkage between diagnosis and treatment

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed microbiological results, clinical presentation, and treatment response.

Common Clinical Scenarios

Patients with severe infections requiring hospitalization and specialized care.

Billing Considerations

Documentation must clearly indicate the type of streptococcus and any complications.

Critical Care

Documentation Requirements

Comprehensive ICU admission notes, treatment protocols, and monitoring data.

Common Clinical Scenarios

Patients with septic shock requiring vasopressors and intensive monitoring.

Billing Considerations

Accurate recording of interventions and patient responses is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use A40.8 When
  • According to ICD
  • 10 guidelines, A40
  • 8 should be used when the specific type of streptococcal sepsis is documented
  • It is essential to ensure that the clinical documentation supports the diagnosis and that the infection is not classified under other sepsis codes

Exclusion Criteria

Do NOT use A40.8 When
No specific exclusions found.

Related CPT Codes

99223CPT Code

Initial hospital care, typically 70 minutes or more

Clinical Scenario

Used when a patient with A40.8 is admitted to the hospital for severe sepsis.

Documentation Requirements

Comprehensive history, examination, and medical decision-making.

Specialty Considerations

Critical care documentation must reflect the complexity of the patient's condition.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of streptococcal sepsis, improving the ability to track and manage these infections. This specificity aids in research and quality improvement initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of streptococcal sepsis, improving the ability to track and manage these infections. This specificity aids in research and quality improvement initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of streptococcal sepsis, improving the ability to track and manage these infections. This specificity aids in research and quality improvement initiatives.

Resources

Clinical References

  • •
    CDC Guidelines for Sepsis Management

Coding & Billing References

  • •
    CDC Guidelines for Sepsis Management

Frequently Asked Questions

What is the difference between A40.8 and other streptococcal sepsis codes?

A40.8 is used for other specified types of streptococcal sepsis that do not fall under the more common categories, such as Group A or Group B streptococcal sepsis. Accurate documentation is essential to justify the use of this code.