B95 - Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere

Specific Coding for Strep as the cause of diseases classified elsewhere

Non-specific codes like B95 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for strep as the cause of diseases classified elsewhere:

Patient Education

Bacterial Infections

Bacteria are living things that have only one cell. Under a microscope, they look like balls, rods, or spirals. They are so small that a line of 1,000 could fit across a pencil eraser. Most types of don't make you sick. Many types are helpful. Some of them help to digest food, destroy disease-causing cells, and give the body needed vitamins. Bacteria are also used in making healthy foods like yogurt and cheese.

But infectious bacteria can make you ill. They reproduce quickly in your body. Many give off chemicals called toxins, which can damage tissue and make you sick. Examples of bacteria that cause infections include Streptococcus, Staphylococcus, and E. coli.

Antibiotics are the usual treatment. When you take antibiotics, follow the directions carefully. Each time you take antibiotics, you increase the chances that bacteria in your body will learn to resist them causing antibiotic resistance. Later, you could get or spread an infection that those antibiotics cannot cure.

NIH: National Institute of Allergy and Infectious Diseases

Staphylococcal Infections

What are Staphylococcal (staph) infections?

Staphylococcus (staph) is a group of bacteria. There are more than 30 types. A type called Staphylococcus aureus causes most infections.

Staph bacteria can cause many different types of infections, including:

• Skin infections, which are the most common types of staph infections
• Bacteremia, an infection of the bloodstream. This can lead to sepsis, a very serious immune response to infection.
• Bone infections
• Endocarditis, an infection of the inner lining of the heart chambers and valves
• Food poisoning
• Pneumonia
• Toxic shock syndrome (TSS), a life-threatening condition caused by toxins from certain types of bacteria

What causes staph infections?

Some people carry staph bacteria on their skin or in their noses, but they do not get an infection. But if they get a cut or wound, the bacteria can enter the body and cause an infection.

Staph bacteria can spread from person to person. They can also spread on objects, such as towels, clothing, door handles, athletic equipment, and remotes. If you have staph and do not handle food properly when you are preparing it, you can also spread staph to others.

Who is at risk for staph infections?

Anyone can develop a staph infection, but certain people are at greater risk, including those who:

• Have a chronic condition such as diabetes, cancer, vascular disease, eczema, and lung disease
• Have a weakened immune system, such as from HIV/AIDS, medicines to prevent organ rejection, or chemotherapy
• Had surgery
• Use a catheter, breathing tube, or feeding tube
• Are on dialysis
• Inject illegal drugs
• Do contact sports, since you may have skin-to-skin contact with others or share equipment

What are the symptoms of staph infections?

The symptoms of a staph infection depend on the type of infection:

• Skin infections can look like pimples or boils. They may be red, swollen, and painful. Sometimes there is pus or other drainage. They can turn into impetigo, which turns into a crust on the skin, or cellulitis, a swollen, red area of skin that feels hot.
• Bone infections can cause pain, swelling, warmth, and redness in the infected area. You may also have chills and a fever.
• Endocarditis causes some flu-like symptoms: fever, chills, and fatigue. It also causes symptoms such as rapid heartbeat, shortness of breath, and fluid buildup in your arms or legs.
• Food poisoning typically causes nausea and vomiting, diarrhea, and a fever. If you lose too many fluids, you may also become dehydrated.
• Pneumonia symptoms include a high fever, chills, and cough that doesn't get better. You may also have chest pain and shortness of breath.
• Toxic shock syndrome (TSS) causes high fever, sudden low blood pressure, vomiting, diarrhea, and confusion. You may have a sunburn-like rash somewhere on your body. TSS can lead to organ failure.

How are staph infections diagnosed?

Your health care provider will do a physical exam and ask about your symptoms. Often, providers can tell if you have a staph skin infection by looking at it. To check for other types of staph infections, providers may do a culture, with a skin scraping, tissue sample, stool sample, or throat or nasal swabs. There may be other tests, such as imaging tests, depending on the type of infection.

What are the treatments for staph infections?

Treatment for staph infections is antibiotics. Depending on the type of infection, you may get a cream, ointment, medicines (to swallow), or intravenous (IV). If you have an infected wound, your provider might drain it. Sometimes you may need surgery for bone infections.

Some staph infections, such as MRSA (methicillin-resistant Staphylococcus aureus), are resistant to many antibiotics. There are still certain antibiotics that can treat these infections.

Can staph infections be prevented?

Certain steps can help to prevent staph infections:

• Use good hygiene, including washing your hands often
• Don't share towels, sheets, or clothing with someone who has a staph infection
• It's best not to share athletic equipment. If you do need to share, make sure that it properly cleaned and dried before you use it.
• Practice food safety, including not preparing food for others when you have a staph infection
• If you have a cut or wound, keep it covered

Streptococcal Infections

Strep is short for Streptococcus, a type of bacteria. There are several types. Two of them cause most of the strep infections in people: group A and group B.

Group A strep causes:

• Strep throat - a sore, red throat. Your tonsils may be swollen and have white spots on them.
• Scarlet fever - an illness that follows strep throat. It causes a red rash on the body.
• Impetigo - a skin infection
• Toxic shock syndrome
• Cellulitis and necrotizing fasciitis (flesh-eating disease)

Group B strep can cause blood infections, pneumonia and meningitis in newborns. A screening test during pregnancy can tell if you have it. If you do, intravenous (IV) antibiotics during labor can save your baby's life. Adults can also get group B strep infections, especially if they are 65 or older or already have health problems. Strep B can cause urinary tract infections, blood infections, skin infections and pneumonia in adults.

Antibiotics are used to treat strep infections.

Code History

• 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
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)