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v1.0.0
ICD-10 Guide
ICD-10 CodesZ22.359

Z22.359

Carrier of Enterobacterales, unspecified

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

Code Description

ICD-10 Z22.359 is a billable code used to indicate a diagnosis of carrier of enterobacterales, unspecified.

Key Diagnostic Point:

Z22.359 is used to classify individuals who are carriers of Enterobacterales, a family of bacteria that includes important pathogens such as Escherichia coli and Klebsiella pneumoniae. These bacteria can be part of the normal flora in the human gut but can also lead to infections, particularly in immunocompromised individuals. Understanding the carrier status is crucial for preventive care, as carriers may not exhibit symptoms but can transmit the bacteria to others, impacting public health. Social determinants 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. Screening for carriers is essential in healthcare settings, especially in hospitals and long-term care facilities, to prevent outbreaks. Aftercare may involve monitoring and education on hygiene practices to reduce transmission risks.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for thorough patient history to establish carrier status.
  • Potential for asymptomatic presentation complicating diagnosis.
  • Variability in documentation practices across healthcare settings.
  • Importance of understanding social determinants affecting carrier status.

Audit Risk Factors

  • Inadequate documentation of carrier status.
  • Failure to link Z code with appropriate clinical scenarios.
  • Misunderstanding of the significance of carrier status in preventive care.
  • Inconsistent coding practices across different providers.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include patient history, risk factors for Enterobacterales, and any preventive measures taken.

Common Clinical Scenarios

Routine checkups where carrier status is assessed, screenings for at-risk populations, and aftercare follow-ups.

Billing Considerations

Consideration of social determinants such as living conditions and access to healthcare services.

Public Health

Documentation Requirements

Documentation should focus on population-level data, surveillance of carrier prevalence, and interventions to reduce transmission.

Common Clinical Scenarios

Epidemiological studies, outbreak investigations, and community health screenings.

Billing Considerations

Emphasis on tracking health status and implementing preventive measures in communities.

Coding Guidelines

Inclusion Criteria

Use Z22.359 When
  • Z codes are used when a patient is not currently ill but has a condition that may affect health status
  • 359 should be sequenced appropriately, often as a secondary diagnosis when related to an encounter for preventive care or screening
  • Payer requirements may vary, so it's essential to check specific guidelines

Exclusion Criteria

Do NOT use Z22.359 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

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

Clinical Scenario

Used when testing for carrier status in a patient.

Documentation Requirements

Documentation of the reason for testing and results.

Specialty Considerations

Primary care providers should ensure they understand the implications of carrier status.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of carrier statuses, improving data accuracy and public health tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carrier statuses, improving data accuracy and public health tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carrier statuses, improving data accuracy and public health tracking.

Resources

Clinical References

  • •
    CDC Guidelines on Enterobacterales

Coding & Billing References

  • •
    CDC Guidelines on Enterobacterales

Frequently Asked Questions

What is the significance of coding Z22.359?

Coding Z22.359 is crucial for identifying carriers of Enterobacterales, which can help in implementing preventive measures and controlling potential outbreaks. It highlights the importance of understanding social determinants that may affect health outcomes.