A40.1
A40.1: Sepsis due to streptococcus, group B
Billable / specific codeICD-10-CM
A40.1 is a billable, specific ICD-10-CM code for sepsis due to streptococcus, group b. It is valid for submission on a claim.
Check A40.1 with the rest of the claim: free scrubberOther codes that can never be billed with A40.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- A41Other sepsis
Risk adjustment
A40.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock0.500 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
A40.1 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56505Billing and Coding: Transesophageal Echocardiography (TEE)
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56625Billing and Coding: Echocardiography
Alphabetic index entries that lead here
- Sepsis›Streptococcus, streptococcal›agalactiae
- Sepsis›Streptococcus, streptococcal›group›B
Code history
Unchanged in every release from FY2024 to FY2027.