A04.1 — Enterotoxigenic Escherichia coli infection
A04.1 is a billable, specific ICD-10-CM code for enterotoxigenic escherichia coli infection. It is valid for submission on a claim.
Risk adjustment
A04.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
A04.1 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58710Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
- A58720Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
- A58747Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
- A58761Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
How A04.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to A04.1.
- Diarrhea, diarrheal›due to›Escherichia coli›enterotoxigenic
- Enteritis›infectious NOS›due to›Escherichia coli›enterotoxigenic
Related codes at this level
Codes that share A04. If A04.1 is not quite right, the correct code is usually one of these.
- A04.0Enteropathogenic Escherichia coli infection
- A04.2Enteroinvasive Escherichia coli infection
- A04.3Enterohemorrhagic Escherichia coli infection
- A04.4Other intestinal Escherichia coli infections
- A04.5Campylobacter enteritis
- A04.6Enteritis due to Yersinia enterocolitica
- A04.7Enterocolitis due to Clostridium difficile
- A04.8Other specified bacterial intestinal infections
- A04.9Bacterial intestinal infection, unspecified
Questions about A04.1
- Is A04.1 a billable ICD-10-CM code?
- Yes. A04.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does A04.1 sit in the tabular list?
- Certain infectious and parasitic diseases (A00-B99), in the block Intestinal infectious diseases (A00-A09).