ICD-10-CM Code for Bacteremia R78. 81.
Bacteremia – Code R78. 81 (Bacteremia). Septicemia – There is NO code for septicemia in ICD-10. Instead, you're directed to a combination 'A' code for sepsis to indicate the underlying infection, such A41.
R78. 81 - Bacteremia | ICD-10-CM.
ICD-10 code B95. 61 for Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere is a medical classification as listed by WHO under the range - Certain infectious and parasitic diseases .
Sepsis due to other specified staphylococcus A41. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM A41. 1 became effective on October 1, 2021.
81, Bacteremia, is a symptom code with an Exclude1 note stating it can't be used with sepsis and that additional documentation related to the cause of the infection, i.e., gram-negative bacteria, salmonella, etc., would be needed for correct code assignment.
Bacteremia is the presence of bacteria in the blood, hence a microbiological finding. Sepsis is a clinical diagnosis needing further specification regarding focus of infection and etiologic pathogen, whereupon clinicians, epidemiologists and microbiologists apply different definitions and terminology.
Clinically, the physician may not be differentiating the diagnoses as two different things, even though coding does. Now, bacteremia is the principal diagnosis, it won't change your DRG, though it could certainly affect quality concerns and medical necessity.
According to the guidelines above, sepsis would be the appropriate principal diagnosis if it is the reason the patient is admitted, and meets the definition of principal diagnosis.
R78. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
MSSA Bacteremia occurs when the MSSA bacteria enter your bloodstream. This is a serious infection that has a high risk of complications and death. Once it's in the bloodstream, the infection often spreads to other organs and tissues within the body such as the heart, lungs, or brain.
Staph can cause serious infections if it gets into the blood and can lead to sepsis or death. Staph is either methicillin-resistant staph (MRSA) or methicillin-susceptible staph (MSSA). Staph can spread in and between hospitals and other healthcare facilities, and in communities.