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ICD-10 Guide
ICD-10 CodesZ22.321

Z22.321

Carrier or suspected carrier of Methicillin susceptible Staphylococcus aureus

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z22.321 is a billable code used to indicate a diagnosis of carrier or suspected carrier of methicillin susceptible staphylococcus aureus.

Key Diagnostic Point:

Z22.321 is used to identify individuals who are carriers or suspected carriers of Methicillin susceptible Staphylococcus aureus (MSSA). This condition is significant as MSSA can lead to serious infections, particularly in immunocompromised individuals or those undergoing invasive procedures. The identification of carriers is crucial for infection control, especially in healthcare settings. Social determinants of health, such as living conditions, access to healthcare, and socioeconomic status, can influence the risk of MSSA colonization and subsequent infections. Preventive measures, including screening and education about hygiene practices, are essential in managing carriers to prevent transmission. Regular follow-ups and aftercare are necessary to monitor the health status of carriers and to implement strategies to reduce the risk of infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough documentation of carrier status and risk factors.
  • Potential for misclassification with other Staphylococcus aureus codes.
  • Variability in clinical presentation and need for differential diagnosis.
  • Importance of social determinants in assessing risk and health outcomes.

Audit Risk Factors

  • Inadequate documentation of carrier status.
  • Failure to link Z code with relevant clinical scenarios.
  • Misuse of Z code when a definitive diagnosis is present.
  • Inconsistent coding practices across different healthcare settings.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, risk factors for MSSA colonization, and preventive measures taken.

Common Clinical Scenarios

Routine checkups where MSSA screening is performed, follow-up visits for carriers, and education on hygiene practices.

Billing Considerations

Consideration of social determinants such as living conditions, access to healthcare, and patient education.

Public Health

Documentation Requirements

Documentation should focus on population-level data, surveillance of MSSA carriers, and preventive strategies implemented.

Common Clinical Scenarios

Epidemiological studies, community health screenings, and public health interventions targeting MSSA transmission.

Billing Considerations

Emphasis on tracking health status and implementing community-wide preventive measures.

Coding Guidelines

Inclusion Criteria

Use Z22.321 When
  • Z codes are used to indicate factors influencing health status and contact with health services
  • 321 should be used when a patient is identified as a carrier or suspected carrier of MSSA
  • It is important to sequence this code appropriately, often as a secondary diagnosis, following any primary diagnosis related to infection or other health issues
  • Payer requirements may vary, so it is essential to verify coverage for preventive screenings

Exclusion Criteria

Do NOT use Z22.321 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

Molecular diagnostic test for Staphylococcus aureus

Clinical Scenario

Used when screening for MSSA in a patient identified as a carrier.

Documentation Requirements

Documentation of the need for screening based on carrier status.

Specialty Considerations

Primary care providers should ensure comprehensive documentation of risk factors.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding carrier statuses, improving the ability to track and manage public health concerns related to MSSA.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding carrier statuses, improving the ability to track and manage public health concerns related to MSSA.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding carrier statuses, improving the ability to track and manage public health concerns related to MSSA.

Resources

Clinical References

  • •
    CDC Guidelines for MSSA Prevention

Coding & Billing References

  • •
    CDC Guidelines for MSSA Prevention

Frequently Asked Questions

When should Z22.321 be used?

Z22.321 should be used when a patient is identified as a carrier or suspected carrier of MSSA, particularly in preventive care and screening contexts.