Is A04.72 a billable ICD-10-CM code?

Yes. A04.72 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does A04.72 sit in the tabular list?

Certain infectious and parasitic diseases (A00-B99), in the block Intestinal infectious diseases (A00-A09).

A04.72

A04.72 — Enterocolitis due to Clostridium difficile, not specified as recurrent

Billable / specific codeICD-10-CM

A04.72 is a billable, specific ICD-10-CM code for enterocolitis due to clostridium difficile, not specified as recurrent. It is valid for submission on a claim.

Risk adjustment

A04.72 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

A04.72 is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A57342Billing and Coding: Diagnostic and Therapeutic Colonoscopy

How A04.72 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 A04.72.

Colitis›Clostridioides difficile›not specified as recurrent
Colitis›Clostridium difficile›not specified as recurrent
Colitis›pseudomembranous›not specified as recurrent
Enteritis›Clostridioides difficile›not specified as recurrent
Enterocolitis›pseudomembranous›not specified as recurrent
Diarrhea, diarrheal›due to›Clostridium difficile›not specified as recurrent
Enteritis›Clostridium›difficile›not specified as recurrent
Enterocolitis›due to›Clostridioides difficile›not specified as recurrent
Enterocolitis›due to›Clostridium difficile›not specified as recurrent
Colitis›toxic NEC›due to›Clostridioides difficile›not specified as recurrent
Colitis›toxic NEC›due to›Clostridium difficile›not specified as recurrent
Enteritis›infectious NOS›due to›Clostridioides difficile›not specified as recurrent

Related codes at this level

Codes that share A04.7. If A04.72 is not quite right, the correct code is usually one of these.

A04.71Enterocolitis due to Clostridium difficile, recurrent

Questions about A04.72

Is A04.72 a billable ICD-10-CM code?: Yes. A04.72 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does A04.72 sit in the tabular list?: Certain infectious and parasitic diseases (A00-B99), in the block Intestinal infectious diseases (A00-A09).