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ICD-10 Guide
ICD-10 CodesA49.02

A49.02

Methicillin resistant Staphylococcus aureus infection, unspecified site

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

Code Description

ICD-10 A49.02 is a billable code used to indicate a diagnosis of methicillin resistant staphylococcus aureus infection, unspecified site.

Key Diagnostic Point:

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to many antibiotics, including methicillin. It can cause a range of infections, from skin and soft tissue infections to more severe infections such as pneumonia, bloodstream infections, and surgical site infections. In immunocompromised patients, MRSA poses a significant risk due to their weakened immune systems, which can lead to opportunistic infections. These patients may include those undergoing chemotherapy, organ transplant recipients, or individuals with chronic diseases. Diagnosing MRSA infections can be challenging, as symptoms may mimic other infections, and laboratory confirmation is often required. Cultures from the site of infection are essential for accurate diagnosis, but in some cases, the infection may be present without clear clinical signs. The unspecified site designation indicates that the infection location is not clearly defined, which can complicate treatment and management strategies. Proper coding is crucial for appropriate reimbursement and tracking of infection rates, especially in healthcare settings where MRSA is a concern.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified site can lead to ambiguity in treatment and management.
  • Requires confirmation through laboratory testing, which may not always be available.
  • Differentiating from other types of Staphylococcus infections can be complex.
  • Documentation must clearly indicate the presence of MRSA to avoid coding errors.

Audit Risk Factors

  • Inadequate documentation of the infection site.
  • Failure to confirm MRSA through laboratory testing.
  • Misclassification of the infection type.
  • Lack of clarity in the patient's immunocompromised status.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's history, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients presenting with skin infections, pneumonia, or post-surgical infections.

Billing Considerations

Ensure that MRSA is confirmed through culture and sensitivity testing.

Oncology

Documentation Requirements

Comprehensive records of the patient's cancer treatment and any immunocompromised status.

Common Clinical Scenarios

Cancer patients developing infections during chemotherapy or after surgery.

Billing Considerations

Document the patient's neutrophil count and any prophylactic measures taken.

Coding Guidelines

Inclusion Criteria

Use A49.02 When
  • According to ICD
  • 10 coding guidelines, A49
  • 02 should be used when the infection is confirmed as MRSA but the site is unspecified
  • Coders must ensure that documentation supports the diagnosis and that laboratory confirmation is available

Exclusion Criteria

Do NOT use A49.02 When
No specific exclusions found.

Related CPT Codes

87070CPT Code

Culture, bacterial, any source

Clinical Scenario

Used when obtaining cultures to confirm MRSA infection.

Documentation Requirements

Document the source of the culture and the clinical indication for testing.

Specialty Considerations

Infectious disease specialists may require additional details on the patient's history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of MRSA infections, improving tracking and management of antibiotic-resistant infections. This specificity aids in better understanding infection patterns and outcomes in various patient populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of MRSA infections, improving tracking and management of antibiotic-resistant infections. This specificity aids in better understanding infection patterns and outcomes in various patient populations.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of MRSA infections, improving tracking and management of antibiotic-resistant infections. This specificity aids in better understanding infection patterns and outcomes in various patient populations.

Resources

Clinical References

  • •
    CDC MRSA Information

Coding & Billing References

  • •
    CDC MRSA Information

Frequently Asked Questions

What is the significance of coding A49.02?

Coding A49.02 is crucial for tracking MRSA infections, which are associated with higher morbidity and healthcare costs. Accurate coding ensures appropriate treatment protocols and resource allocation.