ICD-10 Code B96.1

Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere

Version 2019 Billable Code Unacceptable Principal Diagnosis

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 2019 for the submission of HIPAA-covered transactions.

ICD-10: B96.1
Short Description:Klebsiella pneumoniae as the cause of diseases classd elswhr
Long Description:Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere

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 mandated 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

Information for Medical Professionals

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.

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). The diagnosis code B96.1 is grouped in the following groups for version MS-DRG V36.0 applicable from 10/01/2018 through 09/30/2019.

  • 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

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 041.3 - Klebsiella pneumoniae

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

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:


Information for Patients


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 bacteria won't hurt you - less than 1 percent of the different types make people sick. Many are helpful. Some bacteria 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

  • Actinomycosis (Medical Encyclopedia)
  • Bacterial vaginosis -- aftercare (Medical Encyclopedia)
  • Blood culture (Medical Encyclopedia)
  • Gram stain (Medical Encyclopedia)
  • Gram stain of skin lesion (Medical Encyclopedia)
  • Necrotizing soft tissue infection (Medical Encyclopedia)

[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.