2027 ICD-10-CM Diagnosis Code A54.85Gonococcal peritonitis
ICD-10-CM Codes›A00–B99›A50-A64›A54
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 78
- Not Chronic
A54.85 is a billable ICD-10-CM diagnosis code for gonococcal peritonitis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 371 through 373. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 191 closely related codes. Coders also document this condition as Fitz-Hugh-Curtis syndrome. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Peritonitis and intra-abdominal abscess and Sexually transmitted infections (excluding HIV and hepatitis).
For Medicare Advantage risk adjustment, A54.85 maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation) under the V28 model, adding a risk factor of about 0.326 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
A54.85 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Fitz-Hugh-Curtis syndrome
- Gonococcal perihepatitis
- Gonococcal peritonitis
- Perihepatitis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to A54.85: its own notes plus those printed at block A50-A64 and Chapter 1. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- diseases generally recognized as communicable or transmissible
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- gonococcal pelviperitonitis (A54.24)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- human immunodeficiency virus [HIV] disease (B20)
- carrier or suspected carrier of infectious disease (Z22.-)
- certain localized infections - see body system-related chapters
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
- infectious and parasitic diseases specific to the perinatal period (P35-P39)
- influenza and other acute respiratory infections (J00-J22)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify resistance to antimicrobial drugs (Z16.-)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name A54.85, its category, or a range that includes it.
Applicable To 1
These notes mention A54.85.
Excludes1 3
These codes carry an Excludes1 note naming A54.85: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming A54.85: its condition is not part of those codes, and both may be reported when the patient has both.
- Block P35-P39 Infections specific to the perinatal periodcongenital gonococcal infection (A54.-) names A54.-, which includes this code
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Peritonitis (adhesive) (bacterial) (fibrinous) (hemorrhagic) (idiopathic) (localized) (perforative) (primary) (with adhesions) (with effusion) K65.9
gonococcal A54.85
Syndrome See Also: Disease;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Gonococcal Infection
an infection that is caused by gonococcus.
Patient EducationClinical
Gonorrhea
Gonorrhea is a sexually transmitted infection (STI). It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert A54.85 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About A54.85Overview
What is the ICD-10 code for gonococcal peritonitis?
The ICD-10-CM code for gonococcal peritonitis is A54.85 (sometimes written as A5485). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is A54.85 (Other gonococcal infections) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report gonococcal peritonitis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does A54.85 group to?
When gonococcal peritonitis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 372, 371, 373, with relative weights from 0.6945 to 1.7087 depending on complications. Higher weights mean higher Medicare reimbursement.
Is A54.85 a CC or MCC?
CMS lists A54.85 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 191 closely related codes in its exclusion list.
Can A54.85 be reported with A54.24?
Not as a rule. The Excludes1 note on A54.85 lists "gonococcal pelviperitonitis (A54.24)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is A54.85?
A54.85 (gonococcal peritonitis) maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation), commonly written as HCC 78, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 33 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does A54.85 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, A54.85 adds a risk adjustment factor of about 0.326 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.326 to 0.688 depending on the payment segment). A more severe related category (HCC 77) supersedes it when both are reported. See the full factor table on the HCC 78 category page.
