Tuberculosis ICD-10-CM codes

Active tuberculosis is coded by site. A15 is respiratory TB, with A15.0 for tuberculosis of the lung, A15.6 for tuberculous pleurisy, A15.7 for primary respiratory TB, and A15.9 when the respiratory site is not specified. A17 covers TB of the nervous system (A17.0 tuberculous meningitis), A18 covers all other organs (A18.01 spine, A18.2 peripheral lymph nodes, A18.11 kidney and ureter), and A19 is miliary TB. ICD-10-CM does not require bacteriologic or histologic confirmation; the provider's diagnosis of active TB is sufficient.

Latent TB infection, meaning a positive screen with no active disease, is Z22.7. A positive tuberculin skin test with no evidence of disease and no documented diagnosis of latent TB is R76.11, and a positive interferon-gamma release assay in the same situation is R76.12. Do not assign an A15 to A19 code for a positive test alone. Z20.1 is exposure to a known TB case, and Z11.1 is a routine screening encounter.

Once active disease is treated and resolved, report Z86.11 (personal history of tuberculosis); Z86.15 is history of latent TB infection after completed treatment. Residual conditions attributed to old TB, such as fibrosis or a calcified granuloma, are coded to B90 (B90.9 for respiratory sequelae). Drug-resistant TB does not have a specific code in these categories; add Z16.- for the documented resistance.