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ICD-10 Guide
ICD-10 CodesA41.54

A41.54

Sepsis due to Acinetobacter baumannii

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

Code Description

ICD-10 A41.54 is a billable code used to indicate a diagnosis of sepsis due to acinetobacter baumannii.

Key Diagnostic Point:

Sepsis due to Acinetobacter baumannii is a severe systemic infection characterized by the presence of Acinetobacter baumannii, a gram-negative bacterium, in the bloodstream. This organism is known for its resilience and ability to survive in various environments, making it a common pathogen in healthcare-associated infections, particularly in intensive care units (ICUs). Patients with sepsis may present with symptoms such as fever, chills, rapid heart rate, and confusion, which can rapidly progress to septic shock, characterized by hypotension and multi-organ failure. The management of sepsis due to Acinetobacter baumannii often requires aggressive antimicrobial therapy, as this organism is frequently resistant to multiple antibiotics. Effective treatment necessitates timely identification through blood cultures and susceptibility testing, as well as supportive care in an ICU setting. Antimicrobial stewardship is crucial to prevent the development of further resistance and to optimize patient outcomes. Given the complexity of managing sepsis and the potential for rapid deterioration, healthcare providers must be vigilant in monitoring and documenting clinical changes to ensure appropriate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires accurate identification of the causative organism.
  • Involves understanding of sepsis criteria and definitions.
  • Management often includes multiple interventions and specialties.
  • Documentation must reflect severity and organ dysfunction.

Audit Risk Factors

  • Inadequate documentation of the organism and its resistance.
  • Failure to document the severity of sepsis.
  • Lack of clarity in treatment plans and outcomes.
  • Inconsistent use of sepsis criteria in documentation.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed documentation of culture results, resistance patterns, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever and hypotension in the ICU, requiring broad-spectrum antibiotics.

Billing Considerations

Documentation must include rationale for antibiotic choice and adjustments based on culture results.

Critical Care Medicine

Documentation Requirements

Comprehensive notes on hemodynamic status, organ function, and response to treatment.

Common Clinical Scenarios

Management of septic shock in patients with multi-organ failure.

Billing Considerations

Accurate recording of interventions and their timing is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use A41.54 When
  • According to ICD
  • 10 guidelines, A41
  • 54 should be used when sepsis is confirmed to be due to Acinetobacter baumannii
  • Coders must ensure that documentation supports the diagnosis of sepsis and includes details about the causative organism and any associated complications

Exclusion Criteria

Do NOT use A41.54 When
No specific exclusions found.

Related CPT Codes

87040CPT Code

Culture, bacterial, any source

Clinical Scenario

Used when obtaining cultures to identify Acinetobacter baumannii.

Documentation Requirements

Document the source of the culture and the organism identified.

Specialty Considerations

Infectious disease specialists should ensure cultures are obtained promptly in suspected sepsis cases.

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 sepsis due to Acinetobacter baumannii, improving data accuracy and enhancing the ability to track antibiotic resistance patterns.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infections like sepsis due to Acinetobacter baumannii, improving data accuracy and enhancing the ability to track antibiotic resistance patterns.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of infections like sepsis due to Acinetobacter baumannii, improving data accuracy and enhancing the ability to track antibiotic resistance patterns.

Resources

Clinical References

  • •
    CDC Guidelines for the Prevention of Infections

Coding & Billing References

  • •
    CDC Guidelines for the Prevention of Infections

Frequently Asked Questions

What is the significance of coding A41.54 accurately?

Accurate coding of A41.54 is crucial for appropriate reimbursement, tracking of infection trends, and ensuring that patients receive the correct treatment based on their specific infection.