Is A56.1 a billable ICD-10-CM code?

No. A56.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does A56.1 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).

What cannot be coded together with A56.1?

A56.1 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 A56.1 (A56) and apply to it just the same.

A56.1

A56.1 — Chlamydial infection of pelviperitoneum and other genitourinary organs

Non-billable headerICD-10-CM

A56.1 is a non-billable header ICD-10-CM code for chlamydial infection of pelviperitoneum and other genitourinary organs. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above A56.1

These are not written on A56.1, but they bind it: a note on a category applies to every code beneath it. Billing A56.1 with anything listed here is a denial.

Written on A56 — Other sexually transmitted chlamydial diseases

neonatal chlamydial conjunctivitis (P39.1)
neonatal chlamydial pneumonia (P23.1)

Excludes2 inherited from the categories above A56.1

Also inherited, and the opposite of Excludes1: these conditions are not part of A56.1, but a patient can have both, so you may code both.

Written on A56 — Other sexually transmitted chlamydial diseases

chlamydial lymphogranuloma (A55)
conditions classified to A74.-

Other codes that can never be billed with A56.1

These codes carry an Excludes1 note pointing at A56.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A56.1 alone.

N74Female pelvic inflammatory disorders in diseases classified elsewhere

Risk adjustment

A56.1 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 history

A56.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead A56.1

2 child codes. Green means billable.

Related codes at this level

Codes that share A56. If A56.1 is not quite right, the correct code is usually one of these.

Questions about A56.1

Is A56.1 a billable ICD-10-CM code?: No. A56.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does A56.1 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).
What cannot be coded together with A56.1?: A56.1 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 A56.1 (A56) and apply to it just the same.