2024 ICD-10-CM Diagnosis Code A04.72

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Clostridial enteric disease
• Clostridial gastroenteritis
• Clostridioides difficile infection
• Clostridium difficile colitis
• Clostridium difficile diarrhea
• Clostridium difficile food poisoning
• Clostridium difficile toxin A detected
• Intestinal infection caused by Clostridioides difficile
• Secondary acquired megacolon
• Toxic megacolon due to Clostridium difficile infection
• Toxic state

A04.72 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
371	MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC	06	1.7477
372	MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC	06	1.0423
373	MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC	06	0.7165

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

A0472 replaces the following previously assigned ICD-10-CM code(s):

• A04.7 - Enterocolitis due to Clostridium difficile

Convert A04.72 to ICD-9-CM

• ICD-9-CM Code: 008.45 - Int inf clstrdium dfcile
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

C. diff Infections

What is C. diff?

C. diff is a bacterium that can cause diarrhea and more serious intestinal conditions such as colitis. You may see it called other names - Clostridioides difficile (the new name), Clostridium difficile (an older name), and C. difficile. It causes close to half a million illnesses each year.

What causes C. diff infections?

C. diff bacteria are commonly found in the environment, but people usually only get C. diff infections when they are taking antibiotics. That's because antibiotics not only wipe out bad germs, but they also kill the good germs that protect your body against infections. The effect of antibiotics can last as long as several months. If you come in contact with C. diff germs during this time, you can get sick. You are more likely to get a C. diff infection if you take antibiotics for more than a week.

C. diff spreads when people touch food, surfaces, or objects that are contaminated with feces (poop) from a person who has C. diff.

Who is more likely to develop C. diff infections?

You are at more likely to get a C. diff infection if you:

• Are taking antibiotics
• Are 65 or older
• Recently stayed in a hospital or nursing home
• Have a weakened immune system
• Have had a previous infection with C. diff or were exposed to it

What are the symptoms of C. diff infections?

The symptoms of C. diff infections include:

• Diarrhea (loose, watery stools) or frequent bowel movements for several days
• Fever
• Stomach tenderness or pain
• Loss of appetite
• Nausea

Severe diarrhea causes you to lose a lot of fluids. This can put you at risk for dehydration.

How are C. diff infections diagnosed?

If you have been taking antibiotics recently and have symptoms of a C. diff infection, you should see your health care provider. Your provider will ask about your symptoms and do a lab test of your stool. In some cases, you might also need an imaging test to check for complications.

What are the treatments for C. diff infections?

Certain antibiotics can treat C. diff infections. If you were already taking a different antibiotic when you got C. diff, your provider may ask you to stop taking that one.

If you have a severe case, you may need to stay in the hospital. If you have very severe pain or serious complications, you may need surgery to remove the diseased part of your colon.

About 1 in 5 people who have had a C. diff infection will get it again. It could be that your original infection came back or that you have new infection. Contact your health care provider if your symptoms come back.

Can C. diff infections be prevented?

There are steps you can take to try to prevent getting or spreading C. diff:

• Wash your hands with soap and water after you use the bathroom and before you eat.
• If you have diarrhea, clean the bathroom that you used before anyone else uses it. Use bleach mixed with water or another disinfectant to clean the toilet seat, handle, and lid.

Health care providers can also help prevent C. diff infections by taking infection control precautions and improving how they prescribe antibiotics.

Centers for Disease Control and Prevention

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018