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v1.0.0
ICD-10 Guide
DiagnosesC Difficile Diarrhea

C Difficile Diarrhea

ICD-10 Coding for C. difficile Diarrhea(A04.72, A04.71)

PRIMARY SPECIALTYGastroenterology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is C Difficile Diarrhea?
Essential facts and insights about C. difficile Diarrhea

Key Clinical Considerations:

  • Watery diarrhea (≥3 loose stools per day) for 2 or more days
  • Presence of C. difficile toxins in stool samples
  • Abdominal cramping and tenderness

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of antibiotic use within the last 90 days
  • Laboratory confirmation of C. difficile infection
  • Detailed description of symptoms and duration

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding based on severity (mild, moderate, severe)
  • Common errors include misclassifying the type of diarrhea or failing to document antibiotic history

Code Exclusions

Important Exclusions

  • Irritable bowel syndrome (IBS) and other non-infectious diarrhea causes
  • Alternative codes for non-C. difficile related diarrhea

Related ICD-10 Codes

Primary Codes
A04.7
Enterocolitis due to Clostridium difficile
Ancillary Codes
K52.1
E86.0
Differential Codes
A08.4
K52.89

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Gastroenterology

Specialty Applications

  • Patients with recent antibiotic exposure, elderly patients, and those with underlying health conditions
  • Inpatient and outpatient gastroenterology settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document patient history, symptoms, and lab results.

What are the billing considerations?

Ensure accurate coding to reflect the severity and duration of the condition.