A48.5 — Other specified botulism
A48.5 is a non-billable header ICD-10-CM code for other specified botulism. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- food poisoning due to toxins of Clostridium botulinum (A05.1)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Non-foodborne intoxication due to toxins of Clostridium botulinum [C. botulinum]
Other codes that can never be billed with A48.5
These codes carry an Excludes1 note pointing at A48.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A48.5 alone.
Risk adjustment
A48.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead A48.5
2 child codes. Green means billable.
Related codes at this level
Codes that share A48. If A48.5 is not quite right, the correct code is usually one of these.
Questions about A48.5
- Is A48.5 a billable ICD-10-CM code?
- No. A48.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does A48.5 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 A48.5?
- A48.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.