ICD-10-CM Code B96.1

Valid for Submission

B96.1 is a billable code used to specify a medical diagnosis of klebsiella pneumoniae [k. pneumoniae] as the cause of diseases classified elsewhere. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code B96.1 might also be used to specify conditions or terms like coliform urinary tract infection or urinary tract infection caused by klebsiella.

The code B96.1 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code B96.1 are found in the index:

• - Infection, infected, infective (opportunistic) - B99.9
  • - bacterial NOS - A49.9
    • - as cause of disease classified elsewhere - B96.89
      • - Klebsiella pneumoniae [K. pneumoniae] - B96.1
  • - Klebsiella (K.) pneumoniae NEC - A49.8
    • - as cause of disease classified elsewhere - B96.1

• - Klebsiella (K.) pneumoniae, as cause of disease classified elsewhere - B96.1

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

• Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

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

• Coliform urinary tract infection
• Urinary tract infection caused by Klebsiella

Diagnostic Related Groups

The ICD-10 code B96.1 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2019 through 09/30/2020.

• 867 - OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC
• 868 - OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC
• 869 - OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Convert B96.1 to ICD-9

• 041.3 - Klebsiella pneumoniae

Code Classification

• Certain infectious and parasitic diseases (A00–B99)
  • Bacterial and viral infectious agents (B95-B97)
    • Oth bacterial agents as the cause of diseases classd elswhr (B96)

Code History

• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
  (First year ICD-10-CM implemented into the HIPAA code set)
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Tools

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• Convert B96.1 to ICD-9