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v1.0.0
ICD-10 Guide
ICD-10 CodesA41.3

A41.3

Sepsis due to other specified staphylococcus.

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

Code Description

ICD-10 A41.3 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 a cascade of physiological responses that can result in multi-organ dysfunction and 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 device-related infections. Management typically involves aggressive fluid resuscitation, broad-spectrum antibiotics, and close monitoring in an intensive care unit (ICU) setting. Antimicrobial stewardship is crucial to ensure appropriate antibiotic selection and to minimize the risk of resistance development. Early recognition and treatment are vital to improving patient outcomes and reducing mortality associated with sepsis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various staphylococcal species
  • Understanding the clinical presentation of sepsis
  • Identifying the source of infection
  • Navigating documentation requirements for sepsis

Audit Risk Factors

  • Inadequate documentation of the source of infection
  • Failure to specify the type of staphylococcus
  • Lack of evidence for sepsis diagnosis
  • Inconsistent clinical indicators for sepsis

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed microbiological results, clinical presentation, and treatment response.

Common Clinical Scenarios

Patients with complicated skin infections, endocarditis, or osteomyelitis caused by staphylococci.

Billing Considerations

Ensure clear documentation of the organism and its susceptibility to antibiotics.

Critical Care

Documentation Requirements

Comprehensive notes on hemodynamic status, organ function, and treatment protocols.

Common Clinical Scenarios

Management of septic shock and multi-organ failure in ICU patients.

Billing Considerations

Document all interventions and responses to treatment to support the diagnosis of sepsis.

Coding Guidelines

Inclusion Criteria

Use A41.3 When
  • According to ICD
  • 10 guidelines, sepsis should be coded based on the underlying infection
  • 3 should be used when the specific staphylococcus is identified but is not Staphylococcus aureus
  • Ensure to follow the sequencing rules for sepsis and any associated conditions

Exclusion Criteria

Do NOT use A41.3 When
No specific exclusions found.

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 sepsis in the hospital.

Documentation Requirements

Document history, examination, and medical decision-making.

Specialty Considerations

Critical care specialists should ensure detailed notes on the patient's condition and treatment plan.

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. This specificity aids in better tracking of infection trends and outcomes, which is crucial for quality improvement and research.

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. This specificity aids in better tracking of infection trends and outcomes, which is crucial for quality improvement and research.

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    CDC Sepsis Guidelines

Coding & Billing References

  • •
    CDC Sepsis Guidelines

Frequently Asked Questions

What is the difference between A41.3 and A41.0?

A41.3 is used for sepsis due to other specified staphylococcus species, while A41.0 is specifically for sepsis due to Staphylococcus aureus. Accurate coding depends on identifying the specific organism.