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v1.0.0
ICD-10 Guide
ICD-10 CodesA04.3

A04.3

Enterohemorrhagic Escherichia coli infection

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/04/2025

Code Description

ICD-10 A04.3 is a billable code used to indicate a diagnosis of enterohemorrhagic escherichia coli infection.

Key Diagnostic Point:

A bacterial infection caused by enterohemorrhagic strains of Escherichia coli, which can lead to severe gastrointestinal symptoms, including bloody diarrhea and abdominal cramps.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Severity of symptoms
  • Potential for complications

Audit Risk Factors

    Specialty Focus

    Medical Specialties

    Infectious Disease

    Documentation Requirements

    Detailed clinical history, symptomatology, and laboratory results.

    Common Clinical Scenarios

    Patients presenting with bloody diarrhea and abdominal pain after consuming undercooked meat.

    Billing Considerations

    Consideration of hemolytic uremic syndrome (HUS) as a potential complication.

    Coding Guidelines

    Inclusion Criteria

    Use A04.3 When
    • Ensure accurate documentation of the clinical presentation and any laboratory confirmation of E
    • coli infection

    Exclusion Criteria

    Do NOT use A04.3 When
    No specific exclusions found.

    Related CPT Codes

    87045CPT Code

    Culture, bacterial, any source

    Clinical Scenario

    Testing stool samples for E. coli.

    Documentation Requirements

    Document the reason for testing and clinical symptoms.

    Specialty Considerations

    Infectious disease specialists may require additional tests for confirmation.

    ICD-10 Impact

    Diagnostic & Documentation Impact

    Enhanced Specificity

    ICD-10 Improvements

    Accurate coding impacts treatment protocols and reimbursement for related complications.

    ICD-9 vs ICD-10

    Accurate coding impacts treatment protocols and reimbursement for related complications.

    Reimbursement & Billing Impact

    reimbursement for related complications.

    Resources

    Clinical References

    • •
      CDC - Escherichia coli (E. coli) Infection

    Coding & Billing References

    • •
      CDC - Escherichia coli (E. coli) Infection

    Frequently Asked Questions

    What are the common symptoms of enterohemorrhagic E. coli infection?

    Common symptoms include severe abdominal cramps, diarrhea (often bloody), and vomiting.

    How is enterohemorrhagic E. coli infection diagnosed?

    Diagnosis is typically made through stool culture and laboratory testing for E. coli strains.