A48.1
A48.1: Legionnaires' disease
Billable / specific codeICD-10-CM
A48.1 is a billable, specific ICD-10-CM code for legionnaires' disease. It is valid for submission on a claim.
Check A48.1 with the rest of the claim: free scrubberOther codes that can never be billed with A48.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- J15Bacterial pneumonia, not elsewhere classified
Risk adjustment
A48.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 282 Aspiration and Specified Bacterial Pneumonias0.440 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
A48.1 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
- A57205Billing and Coding: Oximetry Services
Alphabetic index entries that lead here
- Legionellosis
- Disease, diseased›legionnaires'
- Infection, infected, infective›Legionella pneumophila
- Legionnaires'›disease
- Legionnaires'›pneumonia
Code history
Unchanged in every release from FY2024 to FY2027.