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2025 ICD-10-CM code A41.81

Sepsis due to Enterococcus.

Code A41.81 should be used when Enterococcus is confirmed as the causative organism of sepsis.Use additional codes to specify any underlying conditions or complications.

Medical necessity for treatment of sepsis due to Enterococcus is established by the presence of SIRS due to a documented Enterococcus infection, posing an immediate threat to life or health.Treatment addresses the infection and manages systemic complications, potentially preventing organ damage or death.

Physicians diagnose sepsis due to Enterococcus based on symptoms (fever, low blood pressure, difficulty breathing, rapid heart rate, nausea, vomiting, etc.), physical findings, and laboratory tests (blood, urine, stool, joint fluid, or other cultures). Treatment typically involves antibiotic therapy and supportive care, such as oxygen and intravenous fluids.Surgery may be necessary for complications like abscesses or endocarditis. Regular follow-up is essential, especially for patients who develop endocarditis.

In simple words: Sepsis due to Enterococcus is a serious medical condition where the body overreacts to an infection with Enterococcus bacteria in the bloodstream.This can cause a range of symptoms and, if not treated promptly, can be life-threatening.

Sepsis due to Enterococcus refers to a systemic inflammatory response syndrome (SIRS) resulting from an infection with Enterococcus bacteria.This is a serious condition that can be life-threatening.

Example 1: A patient presents to the emergency department with fever, chills, and hypotension. Blood cultures reveal Enterococcus faecalis, and the patient is diagnosed with sepsis due to Enterococcus.The patient is admitted to the ICU and started on intravenous antibiotics and fluids., A patient with a urinary tract infection (UTI) caused by Enterococcus develops worsening symptoms, including confusion and rapid breathing.Blood cultures are positive for Enterococcus, indicating the infection has spread to the bloodstream causing sepsis. The patient is treated with broad-spectrum antibiotics., A patient undergoing chemotherapy for cancer develops a fever and low blood pressure. Blood cultures grow Enterococcus, and the patient is diagnosed with sepsis. This is likely due to the patient's weakened immune system from chemotherapy, making them more susceptible to infections.

Documentation for A41.81 should include: signs and symptoms of sepsis, positive culture identifying Enterococcus as the causative organism, location of infection if known (e.g., urinary tract, wound), and any associated complications (e.g., endocarditis, abscess).

** The presence of sepsis significantly increases the complexity of care and resource utilization.Accurate and complete documentation is crucial for appropriate coding and reimbursement.

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