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v1.0.0
ICD-10 Guide
ICD-10 CodesA96.1

A96.1

Meningococcal spondylitis

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

Code Description

ICD-10 A96.1 is a billable code used to indicate a diagnosis of meningococcal spondylitis.

Key Diagnostic Point:

Meningococcal spondylitis is a rare but serious complication of meningococcal infection, which is caused by the bacterium Neisseria meningitidis. This condition involves inflammation of the vertebrae and surrounding structures due to the spread of the bacteria from the bloodstream or central nervous system to the spinal column. Patients may present with severe back pain, fever, and neurological symptoms, which can include stiffness and altered mental status. Diagnosis typically involves imaging studies such as MRI or CT scans to visualize the spine and rule out other causes of spondylitis. Laboratory tests, including blood cultures and lumbar puncture, may be performed to confirm the presence of meningococcal bacteria. Prompt diagnosis and treatment are crucial, as meningococcal infections can progress rapidly and lead to severe complications, including sepsis and death. Treatment usually involves intravenous antibiotics and supportive care, and in some cases, surgical intervention may be necessary to address abscess formation or spinal instability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of specific bacterial infections and their complications.
  • Differentiation from other types of spondylitis can be challenging.
  • Documentation must clearly indicate the relationship between meningococcal infection and spondylitis.
  • Potential for co-infection with other pathogens complicates coding.

Audit Risk Factors

  • Inadequate documentation linking meningococcal infection to spondylitis.
  • Misclassification of the type of spondylitis.
  • Failure to document travel history or exposure to endemic areas.
  • Lack of supporting lab results or imaging studies.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed history of infection, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever and back pain after recent meningococcal infection.

Billing Considerations

Ensure clear documentation of the infectious source and its complications.

Neurology

Documentation Requirements

Neurological assessments, imaging results, and treatment responses.

Common Clinical Scenarios

Patients with neurological deficits and back pain following meningococcal meningitis.

Billing Considerations

Document neurological evaluations thoroughly to support coding.

Coding Guidelines

Inclusion Criteria

Use A96.1 When
  • According to ICD
  • 10 guidelines, A96
  • 1 should be used when the spondylitis is directly linked to a confirmed meningococcal infection
  • Coders must ensure that the documentation supports the diagnosis and that any related conditions are also coded appropriately

Exclusion Criteria

Do NOT use A96.1 When
No specific exclusions found.

Related CPT Codes

87070CPT Code

Culture, bacterial, any source

Clinical Scenario

Used when confirming the presence of Neisseria meningitidis.

Documentation Requirements

Document the source of the culture and clinical indications.

Specialty Considerations

Infectious disease specialists should ensure cultures are properly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like meningococcal spondylitis, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation linking infections to complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like meningococcal spondylitis, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation linking infections to complications.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the need for detailed documentation linking infections to complications.

Resources

Clinical References

  • •
    CDC Meningococcal Disease Information

Coding & Billing References

  • •
    CDC Meningococcal Disease Information

Frequently Asked Questions

What is the primary cause of meningococcal spondylitis?

Meningococcal spondylitis is primarily caused by the bacterium Neisseria meningitidis, which can spread from the bloodstream to the spinal column.