A06.5: Amebic lung abscess
A06.5 is a billable, specific ICD-10-CM code for amebic lung abscess. It is valid for submission on a claim.
Check A06.5 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Amebic abscess of lung (and liver)
Excludes1 inherited from the categories above A06.5
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above A06.5
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with A06.5
Their own Excludes1 notes name this code, so the conflict is not listed above.
- J99Respiratory disorders in diseases classified elsewhere
Risk adjustment
A06.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 283 Empyema, Lung Abscess0.204 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
A06.5 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
Alphabetic index entries that lead here
- Abscess›amebic›lung(and liver) (without mention of brain abscess)
- Abscess›lung›amebic(with liver abscess)
- Abscess›liver›amebic›with›lung abscess
- Abscess›lung›amebic›with›pneumonia
Code history
Unchanged in every release from FY2024 to FY2027.