A54.5 — Gonococcal pharyngitis
A54.5 is a billable, specific ICD-10-CM code for gonococcal pharyngitis. It is valid for submission on a claim.
Other codes that can never be billed with A54.5
These codes carry an Excludes1 note pointing at A54.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A54.5 alone.
- J02.8Acute pharyngitis due to other specified organisms
Risk adjustment
A54.5 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.
How A54.5 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 A54.5.
- Gonococcus, gonococcal›pharynx
- Gonococcus, gonococcal›throat
- Pharyngitis›gonococcal
Related codes at this level
Codes that share A54. If A54.5 is not quite right, the correct code is usually one of these.
- A54.0Gonococcal infection of lower genitourinary tract without periurethral or accessory gland abscess
- A54.1Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess
- A54.2Gonococcal pelviperitonitis and other gonococcal genitourinary infection
- A54.3Gonococcal infection of eye
- A54.4Gonococcal infection of musculoskeletal system
- A54.6Gonococcal infection of anus and rectum
- A54.8Other gonococcal infections
- A54.9Gonococcal infection, unspecified
Questions about A54.5
- Is A54.5 a billable ICD-10-CM code?
- Yes. A54.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does A54.5 sit in the tabular list?
- Certain infectious and parasitic diseases (A00-B99), in the block Infections with a predominantly sexual mode of transmission (A50-A64).