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.
Inclusion 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
These are not written on A06.5, but they bind it: a note on a category applies to every code beneath it. Billing A06.5 with anything listed here is a denial.
Excludes2 inherited from the categories above A06.5
Also inherited, and the opposite of Excludes1: these conditions are not part of A06.5, but a patient can have both, so you may code both.
Other codes that can never be billed with A06.5
These codes carry an Excludes1 note pointing at A06.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A06.5 alone.
- 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.
Medicare coverage
A06.5 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
How A06.5 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 A06.5.
- 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
A06.5 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share A06. If A06.5 is not quite right, the correct code is usually one of these.
Questions about A06.5
- Is A06.5 a billable ICD-10-CM code?
- Yes. A06.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does A06.5 sit in the tabular list?
- Certain infectious and parasitic diseases (A00-B99), in the block Intestinal infectious diseases (A00-A09).
- What cannot be coded together with A06.5?
- A06.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above A06.5 (A06) and apply to it just the same.