Actinomycosis
In Other bacterial diseases (A30-A49), chapter 1: Certain Infectious and Parasitic Diseases
8 billable codes under A42: 1 is an MCC, 7 are a CC; 1 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.
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Instructional notes
Excludes1: not coded here, use a different code
- actinomycetoma (B47.1)
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 A42
A42 can't be used on a claim. Pick a billable code below; grey headings group them.
A42 MS-DRGs
As the principal diagnosis, the billable codes under A42 group to these 19 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 974 HIV with Major Related Condition with MCC (8 of 8 codes)
- DRG 975 HIV with Major Related Condition with CC (8 of 8 codes)
- DRG 976 HIV with Major Related Condition without CC/MCC (8 of 8 codes)
- DRG 867 Other Infectious and Parasitic Diseases Diagnoses with MCC (4 of 8 codes)
- DRG 868 Other Infectious and Parasitic Diseases Diagnoses with CC (4 of 8 codes)
- DRG 869 Other Infectious and Parasitic Diseases Diagnoses without CC/MCC (4 of 8 codes)
- DRG 177 Respiratory Infections and Inflammations with MCC (1 of 8 codes)
- DRG 178 Respiratory Infections and Inflammations with CC (1 of 8 codes)
- DRG 179 Respiratory Infections and Inflammations without CC/MCC (1 of 8 codes)
- DRG 371 Major Gastrointestinal Disorders and Peritoneal Infections with MCC (1 of 8 codes)
- DRG 372 Major Gastrointestinal Disorders and Peritoneal Infections with CC (1 of 8 codes)
- DRG 373 Major Gastrointestinal Disorders and Peritoneal Infections without CC/MCC (1 of 8 codes)
- DRG 606 Minor Skin Disorders with MCC (1 of 8 codes)
- DRG 607 Minor Skin Disorders without MCC (1 of 8 codes)
- DRG 791 Prematurity with Major Problems (1 of 8 codes)
- DRG 793 Full Term Neonate with Major Problems (1 of 8 codes)
- DRG 870 Septicemia or Severe Sepsis with MV >96 Hours (1 of 8 codes)
- DRG 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC (1 of 8 codes)
- DRG 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC (1 of 8 codes)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Bacterial Infections
Bacteria are tiny organisms (living things) that have only one cell. Under a microscope, they look like balls, rods, or spirals. They can be found almost everywhere on Earth. There are lots of bacteria in and on your body. In fact, your body has about 10 times more bacteria cells than human cells.
Read more about bacterial infections on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.