2025 ICD-10-CM Diagnosis Code A40.3

Sepsis due to Streptococcus pneumoniae

ICD-10-CM Code:
A40.3
ICD-10 Code for:
Sepsis due to Streptococcus pneumoniae
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

A40.3 is a billable diagnosis code used to specify a medical diagnosis of sepsis due to streptococcus pneumoniae. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025.

Code Classification

  • Certain infectious and parasitic diseases
    A00–B99
    • Other bacterial diseases
      A30-A49
      • Streptococcal sepsis
        A40

Approximate Synonyms

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

  • Sepsis caused by Streptococcus pneumoniae
  • Sepsis without acute organ dysfunction caused by Streptococcus pneumoniae
  • Septic shock co-occurrent with acute organ dysfunction caused by Pneumococcus
  • Septic shock co-occurrent with acute organ dysfunction caused by Streptococcus
  • Septic shock co-occurrent with acute organ dysfunction due to Gram-positive coccus

Clinical Classification

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

Bacterial infections

CCSR Code: INF003

Inpatient Default: N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Septicemia

CCSR Code: INF002

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Pneumococcal sepsis

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Convert A40.3 to ICD-9-CM

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

Streptococcal septicemia

ICD-9-CM: 038.0

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Pneumococcal septicemia

ICD-9-CM: 038.2

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Sepsis

ICD-9-CM: 995.91

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Patient Education


Sepsis

What is sepsis?

Sepsis is your body's overactive and extreme response to an infection. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage, organ failure, and even death.

What causes sepsis?

Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Bacterial infections are the most common cause, but other types of infections can also cause it.

The infections are often in the lungs, stomach, kidneys, or bladder. It's possible for sepsis to begin with a small cut that gets infected or with an infection that develops after surgery. Sometimes, sepsis can occur in people who didn't even know that they had an infection.

Who is more likely to develop sepsis?

Anyone with an infection could get sepsis. But certain people are more likely to develop it:

  • Adults 65 or older
  • People with chronic (long-lasting) conditions, such as diabetes, lung disease, cancer, and kidney disease
  • People with weakened immune systems
  • Pregnant women
  • Children younger than one

What are the symptoms of sepsis?

Sepsis can cause one or more of these symptoms:

  • Rapid breathing and heart rate
  • Shortness of breath
  • Confusion or disorientation
  • Extreme pain or discomfort
  • Fever, shivering, or feeling very cold
  • Clammy or sweaty skin

It's important to get medical care right away if you think you might have sepsis or if your infection is not getting better or is getting worse.

What other problems can sepsis cause?

Severe cases of sepsis can lead to septic shock, where your blood pressure drops to a dangerous level and multiple organs can fail.

How is sepsis diagnosed?

To find out if you have sepsis, your health care provider:

  • Will take your medical history, which includes asking about your symptoms
  • Will do a physical exam, which includes checking vital signs (your temperature, blood pressure, heart rate, and breathing)
  • Will likely order lab tests that check for signs of infection or organ damage
  • May order imaging tests such as an x-ray or a CT scan to find the location of the infection

Many of the signs and symptoms of sepsis can also be caused by other medical conditions. This may make sepsis hard to diagnose in its early stages.

What are the treatments for sepsis?

It is very important to get treatment right away. Treatment usually includes:

  • Antibiotics.
  • Maintaining blood flow to organs. This may involve getting oxygen and intravenous (IV) fluids.
  • Treating the source of the infection.
  • If needed, medicines to increase blood pressure.

In serious cases, you might need kidney dialysis or a breathing tube. Some people need surgery to remove tissue damaged by the infection.

Can sepsis be prevented?

To prevent sepsis, you should try to prevent getting an infection:

  • Take good care of any chronic health conditions that you have
  • Get recommended vaccines
  • Practice good hygiene, such as handwashing
  • Keep cuts clean and covered until healed

NIH: National Institute of General Medical SciencesCenters for Disease Control and Prevention


[Learn More in MedlinePlus]

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.


[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
  • 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. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.