R78.81

R78.81: Bacteremia

Billable / specific codeICD-10-CM

R78.81 is a billable, specific ICD-10-CM code for bacteremia. It is valid for submission on a claim.

Check R78.81 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

sepsis-code to specified infection

Excludes2 inherited from the categories above R78.81

Not part of this code, but both may be coded when both are present.

Written on R78: Findings of drugs and other substances, not normally found in blood

mental or behavioral disorders due to psychoactive substance use (F10-F19)

Other codes that can never be billed with R78.81

Their own Excludes1 notes name this code, so the conflict is not listed above.

A41Other sepsis
A49.9Bacterial infection, unspecified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

R78.81 is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52868Billing and Coding: Transesophageal Echocardiography (TEE)
A56505Billing and Coding: Transesophageal Echocardiography (TEE)
A56625Billing and Coding: Echocardiography
A56718Billing and Coding: Intravenous Immunoglobulin (IVIG)

Alphabetic index entries that lead here

Bacteremia
Findings, abnormal, inconclusive, without diagnosis›culture›blood
Positive›culture›blood

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under R78.8

R78.89Finding of other specified substances, not normally found in blood