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2025 ICD-10-CM code A40.9

Streptococcal sepsis, unspecified.

Do not use A40.9 if the specific type of streptococcal sepsis is known.Use additional codes to identify underlying conditions or complications, such as acute organ dysfunction.

Medical necessity for treatment of streptococcal sepsis is established by the life-threatening nature of the condition.The documentation should support the diagnosis of sepsis and the need for interventions such as antibiotics, fluid resuscitation, and other supportive measures.

Clinicians diagnose streptococcal sepsis based on patient history, physical findings, and laboratory tests (blood, urine, wound cultures, etc.). Treatment typically involves antibiotics, and supportive care like dialysis, oxygen, or IV fluids may be necessary. Surgery may be required for abscesses, tissue damage, or organ failure.

In simple words: Streptococcal sepsis is blood poisoning caused by strep bacteria. This can be very serious, even life-threatening. This code is used when the doctor doesn't specify what type of strep bacteria caused the sepsis.

A systemic illness caused by the spread of Streptococcus bacteria in the bloodstream.This code indicates that the specific type of streptococcal sepsis is not identified.

Example 1: A patient presents with fever, chills, rapid heart rate, and low blood pressure following a surgical wound infection. Blood cultures are positive for Streptococcus, but further specification of the bacterial type is not available at the time of coding. A40.9 is used., A patient with pneumonia develops shaking chills, altered mental status, and hypotension. Blood cultures reveal the presence of Streptococcus, but the specific type isn't identified. A40.9 is applicable., An individual with a urinary tract infection experiences worsening symptoms, including fever, confusion, and difficulty breathing.Strep bacteria are detected in their bloodstream, but further typing is pending.A40.9 would be used in this scenario.

Documentation should include evidence of sepsis (e.g., SIRS criteria), positive Streptococcus culture from blood or other relevant site, and signs and symptoms such as fever, chills, altered mental status, hypotension, etc.If possible, document the source of infection (e.g., wound, pneumonia, UTI).If the specific strep type is later identified, update the code accordingly.

** For accurate coding and reimbursement, ensure documentation thoroughly reflects the clinical picture of the patient's condition. It's crucial to note if the infection originated in a healthcare setting (e.g., postoperative or hospital-acquired), as this impacts reporting requirements.

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