Is ICD-10-CM code A41 billable?

No, A41 (Other sepsis) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code A41 belong to?

A41 belongs to Chapter 1 of the ICD-10-CM tabular list: A00–B99 (Certain Infectious and Parasitic Diseases).

A41Not billable, use a more specific code below

Other sepsis

In Other bacterial diseases (A30-A49), chapter 1: Certain Infectious and Parasitic Diseases

15 billable codes under A41: all are an MCC; all map to HCC 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock).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.

Instructional notes

Excludes1: not coded here, use a different code

bacteremia NOS (R78.81)
neonatal (P36.-)
puerperal sepsis (O85)
streptococcal sepsis (A40.-)

Excludes2: not included here, code separately if applicable

sepsis (due to) (in) actinomycotic (A42.7)
sepsis (due to) (in) anthrax (A22.7)
sepsis (due to) (in) candidal (B37.7)
sepsis (due to) (in) Erysipelothrix (A26.7)
sepsis (due to) (in) extraintestinal yersiniosis (A28.2)
sepsis (due to) (in) gonococcal (A54.86)
sepsis (due to) (in) herpesviral (B00.7)
sepsis (due to) (in) listerial (A32.7)
sepsis (due to) (in) melioidosis (A24.1)
sepsis (due to) (in) meningococcal (A39.2-A39.4)
sepsis (due to) (in) plague (A20.7)
sepsis (due to) (in) tularemia (A21.7)
toxic shock syndrome (A48.3)

Code first: code the underlying condition first, then this code

if applicable, postprocedural sepsis (T81.44-)
sepsis due to central venous catheter (T80.211-)
sepsis during labor (O75.3)
sepsis following abortion, ectopic or molar pregnancy (O03.37, O03.87, O04.87, O07.37, O08.82)
sepsis following immunization (T88.0-)
sepsis following infusion, transfusion or therapeutic injection (T80.22-, T80.29-)

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.

Section I.C.1.d Sepsis, Severe Sepsis, and Septic Shock (page 23), covers A41
Code the underlying systemic infection first (A41.9 if unspecified), then a code from R65.2 only when severe sepsis or related acute organ dysfunction is documented, plus organ dysfunction codes. R65.2 codes can never be principal diagnosis.

All codes under A41

A41 can't be used on a claim. Pick a billable code below; grey headings group them.

A41 MS-DRGs

As the principal diagnosis, all 15 billable codes under A41 group to these 8 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to A41

Notes on these codes point to A41.

I5A Code First: sepsis (A41.-)
J95.02 Use Additional Code: sepsis (A40, A41.-)
K94.02 Use Additional Code: sepsis (A40.-, A41.-)
K94.12 Use Additional Code: sepsis (A40.-, A41.-)
K94.22 Use Additional Code: sepsis (A40.-, A41.-)
K95.01 Use Additional Code: sepsis (A40.-, A41.-)
K95.81 Use Additional Code: sepsis (A40.-, A41.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Sepsis

Sepsis is your body's overactive and extreme response to an infection. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage, organ failure, and even death.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.