Chapter 1: Certain Infectious and Parasitic Diseases Quiz

MRSA (Methicillin-Resistant Staphylococcus aureus) Infections

• When a patient is diagnosed with an MRSA infection, assign a combination code that includes the causal organism, e.g. code A41.02 for Sepsis due to Methicillin-resistant Staphylococcus aureus or code J15.212 for Pneumonia due to Methicillin-resistant Staphylococcus aureus.
• Do not assign code B95.62, Methicillin-resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere, as an additional code.

Coding and Sequencing of MRSA Infections

• When there is documentation of a current MRSA infection, assign the appropriate code to identify the condition along with code B95.62, Methicillin-resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere.
• Do not assign a code from subcategory Z16.11, Resistance to penicillins.

Colonization and Carriage of MRSA and MSSA

• Colonization means that MSSA or MRSA is present on or in the body without necessarily causing illness.
• Code only confirmed cases of MRSA colonization.

COVID-19 Coding and Reporting

• Code only confirmed cases of COVID-19 as documented by the provider, or documentation of a positive COVID-19 test result.
• Assign code U07.1, COVID-19, as the principal diagnosis.
• When COVID-19 meets the definition of principal diagnosis, code U07.1 should be sequenced first, followed by the appropriate codes for associated manifestations.

Acute Respiratory Manifestations of COVID-19

• When the reason for the encounter/admission is a respiratory manifestation of COVID-19, assign code U07.1, COVID-19, as the principal diagnosis, and assign code(s) for the respiratory manifestation(s) as additional diagnoses.
• Examples of respiratory manifestations of COVID-19 include:
  • Pneumonia (assign code U07.1 and J12.82, Pneumonia due to coronavirus disease 2019)
  • Acute bronchitis (assign code U07.1 and J20.8, Acute bronchitis due to other specified organisms)
  • Lower respiratory infection (assign code U07.1 and J22, Unspecified acute lower respiratory infection)
  • Acute respiratory distress syndrome (assign code U07.1 and J80, Acute respiratory distress syndrome)
  • Acute respiratory failure (assign code U07.1 and J96.0-, Acute respiratory failure)

Non-Respiratory Manifestations of COVID-19

• When the reason for the encounter/admission is a non-respiratory manifestation of COVID-19, assign code U07.1, COVID-19, as the principal diagnosis, and assign code(s) for the manifestation(s) as additional diagnoses.

Exposure to COVID-19

• For asymptomatic individuals with actual or suspected exposure to COVID-19, assign code Z20.822, Contact with and (suspected) exposure to COVID-19.
• For symptomatic individuals with actual or suspected exposure to COVID-19 and the infection has been ruled out, or test results are inconclusive or unknown, assign code Z20.822, Contact with and (suspected) exposure to COVID-19.

Screening for COVID-19

• For screening for COVID-19, including preoperative testing, assign code Z11.52, Encounter for screening for COVID-19.

HIV (Human Immunodeficiency Virus) Infections

• Code only confirmed cases of HIV infection/illness.
• If a patient is admitted for an HIV-related condition, the principal diagnosis should be B20, Human immunodeficiency virus [HIV] disease, followed by additional diagnosis codes for all reported HIV-related conditions.

Sepsis, Severe Sepsis, and Septic Shock

• The coding of sepsis requires a minimum of 2 codes: first a code for the underlying systemic infection, followed by a code from subcategory R65.2, Severe sepsis.

• If the causal organism is not documented, assign code A41.9, Sepsis, unspecified organism, for the infection.

• Additional code(s) for the associated acute organ dysfunction are also required.### HIV Infections

• Patients with newly diagnosed or previously admitted HIV conditions should have the sequencing decision made independently of these factors.

• Asymptomatic HIV infection is coded as Z21, and should not be used if the patient has AIDS, HIV disease, or is treated for HIV-related illnesses.

Inconclusive HIV Serology

• Patients with inconclusive HIV serology, but no definitive diagnosis or manifestations, are assigned code R75.

Previously Diagnosed HIV-Related Illness

• Patients with a prior diagnosis of HIV-related illness should be coded as B20 on every subsequent admission/encounter.

HIV Infection in Pregnancy, Childbirth, and the Puerperium

• Patients admitted for HIV-related illnesses during pregnancy, childbirth, or the puerperium receive a principal diagnosis code of O98.7-, followed by B20 and the code(s) for the HIV-related illness(es).
• Patients with asymptomatic HIV infection during pregnancy, childbirth, or the puerperium receive codes O98.7 and Z21.

Encounters for HIV Testing

• Patients being seen to determine their HIV status receive code Z11.4.
• Additional codes can be used for associated high-risk behavior.
• Patients with signs or symptoms being seen for HIV testing have their signs and symptoms coded, and may also receive code Z71.7 for HIV counseling.

HIV Managed by Antiretroviral Medication

• Patients with documented HIV disease, HIV-related illness, or AIDS who are managed on antiretroviral medications receive code B20.
• Code Z79.899 may be assigned as an additional code to identify the long-term use of antiretroviral medications.

Encounter for HIV Prophylaxis Measures

• Patients seen for administration of pre-exposure prophylaxis medication for HIV receive code Z29.81.

Infectious Agents as the Cause of Diseases Classified to Other Chapters

• Certain infections classified in chapters other than Chapter 1 do not identify an organism as part of the infection code.
• Sepsis or severe sepsis associated with a non-infectious condition should be sequenced after the non-infectious condition code.

MRSA Colonization and Infection

• Patients documented as having MRSA colonization receive code Z22.322.
• Patients with both MRSA colonization and infection can have both codes assigned.

Zika Virus Infections

• Only confirmed cases of Zika virus disease are coded as A92.5.
• Suspected, possible, or probable Zika cases do not receive code A92.5.