A41.81: Sepsis due to Enterococcus
A41.81 is a billable, specific ICD-10-CM code for sepsis due to enterococcus. It is valid for submission on a claim.
Check A41.81 with the rest of the claim: free scrubberExcludes1 inherited from the categories above A41.81
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above A41.81
Not part of this code, but both may be coded when both are present.
Written on A41: Other sepsis
- sepsis (due to) (in) actinomycotic (A42.7)
- sepsis (due to) (in) anthrax (A22.7)
- sepsis (due to) (in) candidal (B37.7)
- sepsis (due to) (in) Erysipelothrix (A26.7)
- sepsis (due to) (in) extraintestinal yersiniosis (A28.2)
- sepsis (due to) (in) gonococcal (A54.86)
- sepsis (due to) (in) herpesviral (B00.7)
- sepsis (due to) (in) listerial (A32.7)
- sepsis (due to) (in) melioidosis (A24.1)
- sepsis (due to) (in) meningococcal (A39.2-A39.4)
- sepsis (due to) (in) plague (A20.7)
- sepsis (due to) (in) tularemia (A21.7)
- toxic shock syndrome (A48.3)
Other codes that can never be billed with A41.81
Their own Excludes1 notes name this code, so the conflict is not listed above.
- A40Streptococcal sepsis
Risk adjustment
A41.81 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
A41.81 is named in 14 Medicare coverage policies: 14 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›Enterococcus
- Sepsis›Streptococcus, streptococcal›group›D
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.