Diphtheria
In Other bacterial diseases (A30-A49), chapter 1: Certain Infectious and Parasitic Diseases
12 billable codes under A36: all are a CC; 1 map to HCC 227 (Cardiomyopathy/Myocarditis).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Rules for coding infections and parasitic diseases, including HIV, organism and drug resistance codes, sepsis and septic shock, MRSA, Zika, and COVID-19.
- Human Immunodeficiency Virus (HIV) Infections (page 19)
- Infectious agents as the cause of diseases classified to other chapters (page 22)
- Infections resistant to antibiotics (page 22)
- Sepsis, Severe Sepsis, and Septic Shock (page 23)
- Methicillin Resistant Staphylococcus aureus (MRSA) Conditions (page 27)
- Zika virus infections (page 28)
- Coronavirus infections (page 28)
All codes under A36
A36 can't be used on a claim. Pick a billable code below; grey headings group them.
- A36.0Pharyngeal diphtheria
- A36.1Nasopharyngeal diphtheria
- A36.2Laryngeal diphtheria
- A36.3Cutaneous diphtheria
- A36.8Other diphtheria
- A36.81Diphtheritic cardiomyopathy
- A36.82Diphtheritic radiculomyelitis
- A36.83Diphtheritic polyneuritis
- A36.84Diphtheritic tubulo-interstitial nephropathy
- A36.85Diphtheritic cystitis
- A36.86Diphtheritic conjunctivitis
- A36.89Other diphtheritic complications
- A36.9Diphtheria, unspecified
A36 MS-DRGs
As the principal diagnosis, the billable codes under A36 group to these 12 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 867 Other Infectious and Parasitic Diseases Diagnoses with MCC (5 of 12 codes)
- DRG 868 Other Infectious and Parasitic Diseases Diagnoses with CC (5 of 12 codes)
- DRG 869 Other Infectious and Parasitic Diseases Diagnoses without CC/MCC (5 of 12 codes)
- DRG 124 Other Disorders of the Eye with MCC or Thrombolytic Agent (1 of 12 codes)
- DRG 125 Other Disorders of the Eye without MCC (1 of 12 codes)
- DRG 314 Other Circulatory System Diagnoses with MCC (1 of 12 codes)
- DRG 315 Other Circulatory System Diagnoses with CC (1 of 12 codes)
- DRG 316 Other Circulatory System Diagnoses without CC/MCC (1 of 12 codes)
- DRG 606 Minor Skin Disorders with MCC (1 of 12 codes)
- DRG 607 Minor Skin Disorders without MCC (1 of 12 codes)
- DRG 689 Kidney and Urinary Tract Infections with MCC (1 of 12 codes)
- DRG 690 Kidney and Urinary Tract Infections without MCC (1 of 12 codes)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Diphtheria
Diphtheria is a serious bacterial infection. You can catch it from a person who has the infection and coughs or sneezes. You can also get infected by coming in contact with an object, such as a toy, that has bacteria on it.
Read more about diphtheria on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.