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v1.0.0
ICD-10 Guide
ICD-10 CodesB96

B96

Bacterial agents as the cause of diseases classified elsewhere

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

Code Description

ICD-10 B96 is a used to indicate a diagnosis of bacterial agents as the cause of diseases classified elsewhere.

Key Diagnostic Point:

ICD-10 code B96 is utilized to classify bacterial agents that are identified as the cause of diseases that are categorized elsewhere in the ICD-10 system. This category encompasses a variety of bacterial pathogens, including but not limited to, those responsible for infections that do not have a specific code assigned to them in other sections. The significance of this code lies in its ability to provide a more accurate diagnosis and treatment plan by identifying the underlying bacterial cause of a patient's condition. It is essential for healthcare providers to recognize the importance of these agents in the pathogenesis of various diseases, as this can influence treatment decisions and patient outcomes.

  • In clinical practice, B96 codes are particularly relevant when a bacterial infection is suspected or confirmed as a contributing factor to a patient's illness, yet the specific disease is classified under a different category. This allows for a comprehensive understanding of the patient's health status and aids in the development of targeted therapeutic strategies. Proper usage of B96 codes requires careful documentation of the patient's clinical presentation and the relationship between the bacterial agent and the disease being treated, ensuring that all relevant information is captured for accurate coding and billing purposes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of bacterial agents
  • Overlap with other disease classifications
  • Need for precise documentation

Audit Risk Factors

  • Inadequate documentation
  • Misclassification of diseases
  • Failure to link bacterial agents to primary diagnoses

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related Codes

Child Codes

18 codes
B96.0
Pneumococcal meningitis
B96.1
Bacterial pneumonia, not elsewhere classified
B96.2
Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.20
Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.21
Shiga toxin-producing Escherichia coli [E. coli] [STEC] O157 as the cause of diseases classified elsewhere
B96.22
Other specified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhere
B96.23
Unspecified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhere
B96.29
Other Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.3
Mycoplasma pneumoniae as the cause of diseases classified elsewhere
B96.4
Bacterial agents as the cause of diseases classified elsewhere
B96.5
Pseudomonas (aeruginosa) as the cause of diseases classified elsewhere
B96.6
Legionnaires' disease
B96.7
Bacterial agents as the cause of diseases classified elsewhere
B96.8
Other specified bacterial agents as the cause of diseases classified elsewhere
B96.81
Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere
B96.82
Vibrio vulnificus as the cause of diseases classified elsewhere
B96.83
Acinetobacter baumannii as the cause of diseases classified elsewhere
B96.89
Other specified bacterial agents as the cause of diseases classified elsewhere

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of the B96 code category is significant, as it allows for a more nuanced understanding of the role of bacterial infections in various diseases. By accurately coding for bacterial agents, healthcare providers can improve patient management and treatment outcomes, ultimately enhancing the quality of care delivered. Furthermore, the use of B96 codes can contribute to population health data, helping to identify trends in bacterial infections and their association with specific diseases, which can inform public health initiatives and preventive measures.
Administratively, the proper use of B96 codes can lead to improved coding accuracy and reduced audit risks. This can enhance the overall efficiency of healthcare operations and ensure compliance with regulatory requirements. As healthcare continues to evolve with a focus on value-based care, the ability to accurately document and code for bacterial agents will play a crucial role in demonstrating the quality of care provided and in achieving favorable performance metrics.

ICD-9 vs ICD-10

The clinical impact of the B96 code category is significant, as it allows for a more nuanced understanding of the role of bacterial infections in various diseases. By accurately coding for bacterial agents, healthcare providers can improve patient management and treatment outcomes, ultimately enhancing the quality of care delivered. Furthermore, the use of B96 codes can contribute to population health data, helping to identify trends in bacterial infections and their association with specific diseases, which can inform public health initiatives and preventive measures. Administratively, the proper use of B96 codes can lead to improved coding accuracy and reduced audit risks. This can enhance the overall efficiency of healthcare operations and ensure compliance with regulatory requirements. As healthcare continues to evolve with a focus on value-based care, the ability to accurately document and code for bacterial agents will play a crucial role in demonstrating the quality of care provided and in...

Reimbursement & Billing Impact

reimbursement, as payers often require evidence that supports the medical necessity of the services rendered. Additionally, it is important to use the correct CPT codes that correspond to the services provided, as this will facilitate smoother claims processing and reduce the likelihood of denials.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for B96

Coding & Billing References

  • •
    Official ICD-10 Guidelines for B96

Frequently Asked Questions

What conditions are included in B96?

B96 includes a variety of bacterial agents such as those causing infections like tuberculosis, strep throat, and other bacterial infections that do not have a specific code assigned in the ICD-10 system.

When should I use B96 codes?

B96 codes should be used when a bacterial agent is identified as a contributing factor to a disease that is classified elsewhere in the ICD-10, ensuring that the underlying cause of the condition is documented.

What documentation is required for B96?

Documentation should include clinical evidence of the bacterial infection, the relationship between the infection and the primary disease, and any relevant laboratory results that confirm the presence of the bacterial agent.