ICD-10 Guide

A04.7

Enterocolitis due to Clostridium difficile

BILLABLE STATUSNo

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/17/2025

Code Description

ICD-10 A04.7 is a used to indicate a diagnosis of enterocolitis due to clostridium difficile.

Key Diagnostic Point:

Conditions that use this ICD-10 code in their documentation

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Analysis of ICD-10 Code A04
7 - Enterocolitis due to Clostridium difficile Complexity Rating Medium Factors Contributing to Complexity 1
Diagnostic Criteria: - Proper diagnosis requires not only clinical evaluation but also laboratory confirmation via stool testing for C
difficile toxins or the presence of the organism

Audit Risk Factors

Documentation completeness
Coding accuracy verification
Clinical correlation review

Specialty Focus

Medical Specialties

General

Documentation Requirements

ICD-10 code A04.7 refers to Enterocolitis due to Clostridium difficile, a condition that primarily affects the gastrointestinal system and is often associated with antibiotic use. Here are the primary...

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines and documentation requirements

Coding Guidelines

Inclusion Criteria

Use A04.7 When

10 Code A04
Enterocolitis due to Clostridium difficile
Overview
10 code A04
7 is specifically used to denote enterocolitis caused by Clostridium difficile, a bacterium that can cause inflammation of the colon and lead to severe diarrhea, especially following antibiotic use
Accurate coding is essential for proper diagnosis, treatment, and reimbursement
When to Use A04
Related Codes

Exclusion Criteria

Do NOT use A04.7 When

Inclusion and Exclusion Criteria
Exclusion:

Related CPT Codes

No CPT Codes Available

Related CPT codes for this diagnosis will be displayed here when available.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Changes from ICD-9 to ICD-10

1. Code Structure: In ICD-9, the code for Clostridium difficile enterocolitis was 008.45. The transition to ICD-10 introduced a new alphanumeric structure that allows for more detailed classifications. A04.7 is part of a broader category of enterocolitis due to infectious organisms.

ICD-9 vs ICD-10

The implementation of ICD-10 had a significant impact on the coding and classification of various diseases, including code A04.7, which refers to "Enterocolitis due to Clostridium difficile." Below is a detailed analysis of the changes and implications associated with this specific code: Changes from ICD-9 to ICD-10 1. Code Structure: In ICD-9, the code for Clostridium difficile enterocolitis was 008.45. The transition to ICD-10 introduced a new alphanumeric structure that allows for more detailed classifications. A04.7 is part of a broader category of enterocolitis due to infectious organisms. 2. Expanded Classification: ICD-10 offers a more specific coding framework that distinguishes between different pathogens and related conditions, providing greater granularity. This allows for better tracking and management of enterocolitis cases related to Clostridium difficile. Specificity Improvements 1. Detailed Clinical Information: ICD-10 codes include additional characters that can specify the type, severity, and complications associated with a diagnosis. For example, A04.7 specifically...

A04.7

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions

A04.7

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions