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v1.0.0
ICD-10 Guide
ICD-10 CodesA41.2

A41.2

Sepsis due to other specified staphylococcus.

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

Code Description

ICD-10 A41.2 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 caused by the presence of staphylococcal bacteria in the bloodstream. This condition is characterized by a dysregulated host response to infection, leading to widespread inflammation, tissue damage, and potential organ dysfunction. Staphylococcus species, particularly Staphylococcus aureus and coagulase-negative staphylococci, are common pathogens in sepsis cases. Patients may present with symptoms such as fever, chills, rapid heart rate, and altered mental status. The diagnosis of sepsis requires a combination of clinical evaluation and laboratory findings, including blood cultures that identify the specific staphylococcus strain. Management typically involves aggressive fluid resuscitation, broad-spectrum antibiotics, and supportive care in an intensive care unit (ICU) setting. Antimicrobial stewardship is crucial to optimize antibiotic use, minimize resistance, and improve patient outcomes. Early recognition and treatment are vital to reduce morbidity and mortality associated with sepsis due to staphylococcus.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of staphylococcal infections.
  • Need for precise documentation of the source of infection.
  • Understanding the nuances of sepsis criteria and staging.
  • Potential for co-infections complicating the clinical picture.

Audit Risk Factors

  • Inadequate documentation of the causative organism.
  • Failure to meet sepsis criteria in clinical documentation.
  • Misclassification of the type of staphylococcus involved.
  • Lack of clarity on the source of infection.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed microbiological data and clinical correlation.

Common Clinical Scenarios

Patients with complicated infections requiring hospitalization.

Billing Considerations

Need for accurate identification of the pathogen and its resistance profile.

Critical Care Medicine

Documentation Requirements

Comprehensive documentation of organ dysfunction and treatment response.

Common Clinical Scenarios

Management of septic shock in ICU patients.

Billing Considerations

Focus on hemodynamic monitoring and fluid management.

Coding Guidelines

Inclusion Criteria

Use A41.2 When
  • According to ICD
  • 10 guidelines, A41
  • 2 should be used when the sepsis is specifically due to a staphylococcus species that is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis of sepsis and the specific organism involved

Exclusion Criteria

Do NOT use A41.2 When
No specific exclusions found.

Related CPT Codes

99223CPT Code

Initial hospital care, high complexity

Clinical Scenario

Used for patients admitted with severe sepsis.

Documentation Requirements

Comprehensive history, examination, and medical decision-making.

Specialty Considerations

Critical care documentation must reflect the severity of the condition.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sepsis, including the ability to identify the causative organism, which aids in better tracking of infection trends and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sepsis, including the ability to identify the causative organism, which aids in better tracking of infection trends and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sepsis, including the ability to identify the causative organism, which aids in better tracking of infection trends and outcomes.

Resources

Clinical References

  • •
    CDC Sepsis Guidelines

Coding & Billing References

  • •
    CDC Sepsis Guidelines

Frequently Asked Questions

What is the importance of specifying the type of staphylococcus in sepsis coding?

Specifying the type of staphylococcus is crucial for accurate coding, treatment decisions, and understanding the epidemiology of infections. It also impacts antimicrobial stewardship efforts.