A50-A64 — Infections with a predominantly sexual mode of transmission
ICD-10-CM codes A50-A64 cover infections with a predominantly sexual mode of transmission, within certain infectious and parasitic diseases. The block holds 169 codes across 13 categories, of which 142 are billable and 27 are header codes that cannot be submitted on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- human immunodeficiency virus [HIV] disease (B20)
Risk adjustment in A50-A64
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
- HCC 78 Intestinal Obstruction/Perforation
What else to watch in A50-A64
- 80 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in A50-A64
- A50Congenital syphilis
- A51Early syphilis
- A52Late syphilis
- A53Other and unspecified syphilis
- A54Gonococcal infection
- A55Chlamydial lymphogranuloma (venereum)
- A56Other sexually transmitted chlamydial diseases
- A57Chancroid
- A58Granuloma inguinale
- A59Trichomoniasis
- A60Anogenital herpesviral [herpes simplex] infections
- A63Other predominantly sexually transmitted diseases, not elsewhere classified
- A64Unspecified sexually transmitted disease