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v1.0.0
ICD-10 Guide
ICD-10 CodesA41.1

A41.1

Sepsis due to other specified staphylococcus.

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

Code Description

ICD-10 A41.1 is a billable code used to indicate a diagnosis of sepsis due to other specified staphylococcus..

Key Diagnostic Point:

Sepsis due to other specified staphylococcus refers to a systemic inflammatory response syndrome (SIRS) triggered by an infection caused by staphylococcal species that are not classified as Staphylococcus aureus. This condition is characterized by the presence of bacteria in the bloodstream, leading to widespread inflammation, tissue damage, and potential organ failure. Patients with this type of sepsis often present with symptoms such as fever, chills, rapid heart rate, and altered mental status. The condition can arise from various sources, including skin infections, pneumonia, or surgical site infections. Prompt recognition and treatment are critical, as sepsis can rapidly progress to severe sepsis or septic shock, necessitating intensive care unit (ICU) management. Effective antimicrobial stewardship is essential in treating sepsis due to staphylococcus, as inappropriate antibiotic use can lead to resistance and treatment failure. Clinicians must carefully select appropriate antibiotics based on culture results and local resistance patterns to optimize patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various staphylococcal species.
  • Understanding the clinical presentation of sepsis versus other infections.
  • The need for precise documentation of the source of infection.
  • Potential overlap with other sepsis codes.

Audit Risk Factors

  • Inadequate documentation of the source of infection.
  • Failure to specify the type of staphylococcus involved.
  • Misclassification of sepsis severity.
  • Inconsistent use of clinical indicators for sepsis diagnosis.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed notes on the patient's clinical presentation, laboratory results, and treatment plan.

Common Clinical Scenarios

Patients presenting with fever and signs of infection, requiring culture and sensitivity testing.

Billing Considerations

Documentation must clearly indicate the organism identified and its susceptibility to antibiotics.

Critical Care Medicine

Documentation Requirements

Comprehensive ICU admission notes, including vital signs, lab results, and response to treatment.

Common Clinical Scenarios

Patients with severe sepsis or septic shock requiring intensive monitoring and intervention.

Billing Considerations

Accurate coding of sepsis severity is crucial for appropriate reimbursement and quality metrics.

Coding Guidelines

Inclusion Criteria

Use A41.1 When
  • According to ICD
  • 10 coding guidelines, A41
  • 1 should be used when the sepsis is specifically due to other specified staphylococcus
  • Coders must ensure that the documentation supports the diagnosis and that the infection source is clearly identified

Exclusion Criteria

Do NOT use A41.1 When
No specific exclusions found.

Related CPT Codes

99223CPT Code

Initial hospital care, high complexity

Clinical Scenario

Used for patients admitted with severe sepsis requiring extensive evaluation.

Documentation Requirements

Comprehensive documentation of history, examination, and medical decision-making.

Specialty Considerations

Critical care specialists should ensure that all elements of the visit are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sepsis, improving the ability to track and manage infections. A41.1 provides granularity that aids in understanding the epidemiology of infections caused by less common staphylococcal species.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sepsis, improving the ability to track and manage infections. A41.1 provides granularity that aids in understanding the epidemiology of infections caused by less common staphylococcal species.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sepsis, improving the ability to track and manage infections. A41.1 provides granularity that aids in understanding the epidemiology of infections caused by less common staphylococcal species.

Resources

Clinical References

  • •
    CDC Sepsis Guidelines

Coding & Billing References

  • •
    CDC Sepsis Guidelines

Frequently Asked Questions

What is the difference between A41.1 and A41.0?

A41.1 is used for sepsis due to other specified staphylococcus, while A41.0 is specifically for sepsis due to Staphylococcus aureus. Accurate coding depends on the identification of the causative organism.