Is A42.7 a billable ICD-10-CM code?

Yes. A42.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does A42.7 sit in the tabular list?

Certain infectious and parasitic diseases (A00-B99), in the block Other bacterial diseases (A30-A49).

What cannot be coded together with A42.7?

A42.7 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 A42.7 (A42) and apply to it just the same.

A42.7

A42.7 — Actinomycotic sepsis

Billable / specific codeICD-10-CM

A42.7 is a billable, specific ICD-10-CM code for actinomycotic sepsis. It is valid for submission on a claim.

Excludes1 inherited from the categories above A42.7

These are not written on A42.7, but they bind it: a note on a category applies to every code beneath it. Billing A42.7 with anything listed here is a denial.

Written on A42 — Actinomycosis

actinomycetoma (B47.1)

Risk adjustment

A42.7 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.

Medicare coverage

A42.7 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.

A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56625Billing and Coding: Echocardiography
A56781Billing and Coding: Transthoracic Echocardiography (TTE)

How A42.7 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 A42.7.

Actinomycosis, actinomycotic›sepsis
Sepsis›actinomycotic

Code history

A42.7 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 A42. If A42.7 is not quite right, the correct code is usually one of these.

Questions about A42.7

Is A42.7 a billable ICD-10-CM code?: Yes. A42.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does A42.7 sit in the tabular list?: Certain infectious and parasitic diseases (A00-B99), in the block Other bacterial diseases (A30-A49).
What cannot be coded together with A42.7?: A42.7 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 A42.7 (A42) and apply to it just the same.