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v1.0.0
ICD-10 Guide
ICD-10 CodesA54.42

A54.42

Gonococcal arthritis

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

Code Description

ICD-10 A54.42 is a billable code used to indicate a diagnosis of gonococcal arthritis.

Key Diagnostic Point:

Gonococcal arthritis is a type of inflammatory arthritis caused by the Neisseria gonorrhoeae bacterium, which is primarily transmitted through sexual contact. This condition typically presents with joint pain, swelling, and inflammation, often affecting the knees, wrists, and ankles. Patients may also exhibit systemic symptoms such as fever and malaise. Gonococcal arthritis can occur as a complication of disseminated gonococcal infection (DGI), where the bacteria spread from the initial site of infection, often the urogenital tract, to the joints. Diagnosis is confirmed through synovial fluid analysis, culture, and serological tests. Prompt treatment is crucial to prevent joint damage and involves the use of antibiotics, with ceftriaxone being a common choice. In addition to treating the infection, it is essential to conduct contact tracing to identify and treat sexual partners to prevent further transmission of the infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of sexually transmitted infections (STIs)
  • Need for accurate documentation of clinical presentation
  • Potential for co-infection with other STIs
  • Importance of contact tracing and partner notification

Audit Risk Factors

  • Inadequate documentation of sexual history
  • Failure to document contact tracing efforts
  • Misdiagnosis or coding of non-gonococcal arthritis
  • Lack of supporting lab results

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed history of sexual activity, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with joint pain and a history of STIs.

Billing Considerations

Need for comprehensive STI screening and partner notification.

Rheumatology

Documentation Requirements

Clinical evaluation of joint symptoms, lab results, and treatment response.

Common Clinical Scenarios

Patients with joint swelling and systemic symptoms, requiring differentiation from other arthritides.

Billing Considerations

Consideration of co-existing autoimmune conditions.

Coding Guidelines

Inclusion Criteria

Use A54.42 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, including the need for specificity in the type of arthritis and associated infections
  • gonococcal arthritis

Exclusion Criteria

Do NOT use A54.42 When
  • Exclude codes for non

Related CPT Codes

87070CPT Code

Culture, bacterial, any source

Clinical Scenario

Used when confirming the diagnosis of gonococcal arthritis.

Documentation Requirements

Document the source of the culture and the organism identified.

Specialty Considerations

Infectious disease specialists may require additional tests for comprehensive STI screening.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gonococcal arthritis, improving the accuracy of data collection and treatment tracking for STIs.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gonococcal arthritis, improving the accuracy of data collection and treatment tracking for STIs.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of gonococcal arthritis, improving the accuracy of data collection and treatment tracking for STIs.

Resources

Clinical References

  • •
    CDC Gonorrhea Treatment Guidelines

Coding & Billing References

  • •
    CDC Gonorrhea Treatment Guidelines

Frequently Asked Questions

What are the common symptoms of gonococcal arthritis?

Common symptoms include joint pain, swelling, and inflammation, often accompanied by systemic symptoms like fever and malaise.

How is gonococcal arthritis diagnosed?

Diagnosis is made through clinical evaluation, synovial fluid analysis, and cultures for Neisseria gonorrhoeae.

What is the treatment for gonococcal arthritis?

Treatment typically involves antibiotics, with ceftriaxone being a common choice, along with supportive care for joint symptoms.