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ICD-10 Guide
ICD-10 CodesA41.02

A41.02

Sepsis due to Methicillin resistant Staphylococcus aureus

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

Code Description

ICD-10 A41.02 is a billable code used to indicate a diagnosis of sepsis due to methicillin resistant staphylococcus aureus.

Key Diagnostic Point:

Sepsis due to Methicillin-resistant Staphylococcus aureus (MRSA) is a severe systemic infection characterized by the presence of MRSA in the bloodstream, leading to a dysregulated immune response. MRSA is a strain of Staphylococcus aureus that has developed resistance to methicillin and other beta-lactam antibiotics, making it a significant cause of healthcare-associated infections. Patients with MRSA sepsis often present with symptoms such as fever, chills, tachycardia, and altered mental status. The condition can rapidly progress to septic shock, characterized by hypotension and multi-organ dysfunction, necessitating immediate medical intervention. Treatment typically involves the use of appropriate antibiotics, such as vancomycin or linezolid, and supportive care in an intensive care unit (ICU) setting. The management of MRSA sepsis requires careful monitoring of antibiotic susceptibility patterns and adherence to antimicrobial stewardship principles to prevent the development of further resistance. Early recognition and aggressive treatment are crucial for improving patient outcomes in this high-risk population.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for precise identification of the causative organism (MRSA)
  • Differentiation from other types of sepsis
  • Documentation of severity and organ dysfunction
  • Potential for co-infections or complications

Audit Risk Factors

  • Inadequate documentation of the organism causing sepsis
  • Failure to document the severity of illness
  • Lack of clarity in treatment plans and outcomes
  • Inconsistent use of sepsis screening tools

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed microbiological results, treatment plans, and response to therapy.

Common Clinical Scenarios

Patients presenting with fever and suspected sepsis, requiring culture and sensitivity testing.

Billing Considerations

Documentation must clearly indicate the source of infection and any prior antibiotic use.

Critical Care

Documentation Requirements

Comprehensive notes on hemodynamic status, organ function, and interventions.

Common Clinical Scenarios

Management of patients in the ICU with severe sepsis or septic shock.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use A41.02 When
  • According to ICD
  • 10 guidelines, A41
  • 02 should be used when sepsis is confirmed to be due to MRSA
  • Coders must ensure that the documentation supports the diagnosis of sepsis and the specific organism involved

Exclusion Criteria

Do NOT use A41.02 When
  • Exclusion criteria include cases where the organism is not identified or where sepsis is due to other pathogens

Related CPT Codes

99223CPT Code

Initial hospital care, typically 70 minutes or more

Clinical Scenario

Used for the initial evaluation and management of a patient with MRSA sepsis in the ICU.

Documentation Requirements

Comprehensive history, examination, and medical decision-making details.

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 infections like MRSA sepsis, improving data accuracy and facilitating better tracking of antibiotic resistance patterns.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infections like MRSA sepsis, improving data accuracy and facilitating better tracking of antibiotic resistance patterns.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of infections like MRSA sepsis, improving data accuracy and facilitating better tracking of antibiotic resistance patterns.

Resources

Clinical References

  • •
    CDC Guidelines for the Prevention of MRSA Infections

Coding & Billing References

  • •
    CDC Guidelines for the Prevention of MRSA Infections

Frequently Asked Questions

What is the significance of coding A41.02?

Coding A41.02 accurately reflects the presence of MRSA as the causative agent of sepsis, which is crucial for appropriate treatment and tracking of antibiotic resistance.