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ICD-10 Guide
ICD-10 CodesZ22.350

Z22.350

Carrier of carbapenem-resistant Enterobacterales

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

Code Description

ICD-10 Z22.350 is a billable code used to indicate a diagnosis of carrier of carbapenem-resistant enterobacterales.

Key Diagnostic Point:

Z22.350 identifies individuals who are carriers of carbapenem-resistant Enterobacterales (CRE), a group of bacteria that are resistant to carbapenem antibiotics. This resistance poses significant challenges in healthcare settings, as these organisms can lead to severe infections that are difficult to treat. Carriers may not exhibit symptoms but can transmit the bacteria to others, making it crucial for healthcare providers to identify and manage these individuals. Social determinants of health, such as access to healthcare, socioeconomic status, and living conditions, can influence the risk of becoming a carrier and the ability to receive preventive care. Preventive measures include screening in high-risk populations, such as those in long-term care facilities or with recent hospitalizations. Aftercare may involve monitoring and education on hygiene practices to prevent transmission. Understanding the broader context of health status and healthcare access is essential for effective management and coding of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate identification of carrier status versus active infection
  • Documentation of patient history and risk factors
  • Understanding of social determinants affecting health outcomes
  • Potential for co-morbid conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of carrier status versus active infection
  • Failure to document risk factors or social determinants
  • Misuse of the code in non-relevant clinical scenarios
  • Inconsistent coding practices across different providers

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, risk factors for CRE, and any preventive measures taken. Routine screenings and follow-up care should be clearly noted.

Common Clinical Scenarios

Routine checkups for high-risk patients, screenings for CRE in patients with recent hospitalizations, and aftercare for carriers.

Billing Considerations

Consideration of social determinants such as living conditions, access to healthcare, and education on hygiene practices.

Public Health

Documentation Requirements

Documentation should focus on population-level data, including prevalence rates and tracking of CRE carriers in the community.

Common Clinical Scenarios

Epidemiological studies, community health screenings, and preventive health initiatives targeting high-risk populations.

Billing Considerations

Emphasis on reporting and tracking health status to inform public health interventions.

Coding Guidelines

Inclusion Criteria

Use Z22.350 When
  • Z codes are used to indicate factors influencing health status and contact with health services
  • 350 should be used when a patient is identified as a carrier of CRE without active infection
  • It is important to sequence this code appropriately, often following any primary diagnosis
  • Payer requirements may vary, so it is essential to verify coverage for preventive screenings and follow
  • up care

Exclusion Criteria

Do NOT use Z22.350 When
No specific exclusions found.

Related CPT Codes

87430CPT Code

Infectious agent detection by nucleic acid (DNA or RNA); Enterobacterales

Clinical Scenario

Used when testing for CRE in a patient identified as a carrier.

Documentation Requirements

Documentation of the reason for testing and the patient's carrier status.

Specialty Considerations

Primary care providers should ensure that testing aligns with preventive care guidelines.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding, particularly for conditions like Z22.350. This specificity aids in better tracking and management of carriers, which is crucial for infection control efforts.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding, particularly for conditions like Z22.350. This specificity aids in better tracking and management of carriers, which is crucial for infection control efforts.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding, particularly for conditions like Z22.350. This specificity aids in better tracking and management of carriers, which is crucial for infection control efforts.

Resources

Clinical References

  • •
    CDC Guidelines on Carbapenem-resistant Enterobacterales

Coding & Billing References

  • •
    CDC Guidelines on Carbapenem-resistant Enterobacterales

Frequently Asked Questions

What should be documented to support the use of Z22.350?

Documentation should include the patient's carrier status, any relevant risk factors, preventive measures taken, and follow-up care plans. It is also important to note any social determinants that may impact the patient's health.